Organization Active NPI

Betsy Brogan DPM Inc

  • Podiatrist
  • Cincinnati, OH
National Provider Identifier
1972810562
Registry record updated Mar 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36003262 Issued in OH
Legal business name
BETSY BROGAN DPM INC
Practice address
2925 Vernon PL
Suite 302
Cincinnati, OH 45219-2425
Phone
(513) 381-4042
Fax
(513) 345-6632
NPI assigned
Sep 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Betsy A Brogan, DPMNPI 1851316798
Title
Podiatrist
Phone
(513) 381-4042

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 36003262 OH Primary

Addresses

Primary practice location

2925 Vernon PL
Suite 302
Cincinnati, OH 45219-2425

Mailing address

6200 Pleasant Ave
Suite 3
Fairfield, OH 45014-4670
Phone (513) 829-9333

Other identifiers 1

IdentifierTypeStateIssuer
3089385MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040302000226 OH Part B Supplier - Clinic/Group Practice 9931096294 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Cincinnati, OH

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

2925 Vernon Pl
Ste 302
Cincinnati, OH 45219
Phone (513) 381-4042

7691 5 Mile Rd
Ste 301
Cincinnati, OH 45230
Phone (513) 232-8880

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1283472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458518400000",
    "number": "1972810562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 PLEASANT AVE",
            "address_2": "SUITE 3",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450144670",
            "telephone_number": "513-829-9333",
            "fax_number": "513-858-7827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 VERNON PL",
            "address_2": "SUITE 302",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192425",
            "telephone_number": "513-381-4042",
            "fax_number": "513-345-6632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETSY BROGAN DPM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-03",
        "last_updated": "2016-03-21",
        "status": "A",
        "authorized_official_last_name": "BROGAN",
        "authorized_official_first_name": "BETSY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "513-381-4042",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36003262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3089385",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.