Active NPI
Mariano Fernandez-Ulloa, MD
- Nuclear Medicine Physician
- Cincinnati, OH
National Provider Identifier
1982793303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nuclear Medicine Physician
- License
- 35-04-0051-F
- Practice address
- 234 Goodman St
Cincinnati, OH 45267-1000 - Phone
- (513) 584-2146
- Fax
- (513) 584-0431
- NPI assigned
- Oct 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nuclear Medicine Physician | 207U00000X | 35-04-0051-F | OH | Primary |
Addresses
Primary practice location
234 Goodman St
Cincinnati, OH 45267-1000
Mailing address
3200 Burnet Ave
3 South
Cincinnati, OH 45229-3019
Phone (513) 585-5501
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000013583 | Other | OH | ANTHEM |
| 64781354 | Medicaid | KY | |
| 0377702 | Medicaid | OH | |
| 3820017 | Other | OH | UNITED HEALTHCARE |
| 200038970A | Medicaid | IN | |
| 655277 | Other | OH | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1356566400000",
"number": "1982793303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 BURNET AVE",
"address_2": "3 SOUTH",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452293019",
"telephone_number": "513-585-5501",
"fax_number": "513-585-5511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "234 GOODMAN ST",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452671000",
"telephone_number": "513-584-2146",
"fax_number": "513-584-0431"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ-ULLOA",
"first_name": "MARIANO",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2012-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "207U00000X",
"taxonomy_group": "",
"desc": "Nuclear Medicine",
"state": "OH",
"license": "35-04-0051-F",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000013583",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64781354",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0377702",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "3820017",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200038970A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "655277",
"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 Dec 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.