Providence Medical Group - Medicare in Dayton, OH

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Providence Medical Group is a medicare enrolled "Family Medicine" provider in Dayton, Ohio. Their current practice location is 2912 Springboro Rd W, Suite 201, Dayton, Ohio. You can reach out to their office (for appointments etc.) via phone at (937) 297-8999.

Providence Medical Group is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Providence Medical Group is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1972533149.

Contact Information

Providence Medical Group
2912 Springboro Rd W, Suite 201,
Dayton, OH 45439-1674
(937) 297-8999
(937) 297-4852

Map and Direction




Healthcare Provider's Profile

Full NameProvidence Medical Group
TypeFacility
SpecialityFamily Medicine
Location2912 Springboro Rd W, Dayton, Ohio
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1972533149
  • Provider Enumeration Date: 07/04/2006
  • Last Update Date: 10/19/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 2860386349
  • Enrollment ID: O20040215000006

Medical Identifiers

Medical identifiers for Providence Medical Group such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1972533149NPI-NPPES
2380294MedicaidOH

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
133V00000XDietitian, Registered (Ohio)Secondary
163WD0400XRegistered Nurse - Diabetes Educator (Ohio)Secondary
207Q00000XFamily Medicine (* (Not Available))Primary
207V00000XObstetrics & Gynecology (* (Not Available))Secondary
208000000XPediatrics (* (Not Available))Secondary
208600000XSurgery (* (Not Available))Secondary
2088F0040XUrology - Female Pelvic Medicine And Reconstructive Surgery (* (Not Available))Secondary
208C00000XColon & Rectal Surgery (* (Not Available))Secondary
208D00000XGeneral Practice (* (Not Available))Secondary
291U00000XClinical Medical Laboratory (* (Not Available))Secondary
363AM0700XPhysician Assistant - Medical (* (Not Available))Secondary
363L00000XNurse Practitioner 1313008 (Ohio)Secondary
363LA2100XNurse Practitioner - Acute Care (* (Not Available))Secondary
363LA2200XNurse Practitioner - Adult Health (* (Not Available))Secondary
363LP0200XNurse Practitioner - Pediatrics (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Providence Medical Group acts as a billing entity for following providers:
Provider NameMark Stuart Jeffries
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1568458040
PECOS PAC ID: 6901701309
Enrollment ID: I20031126000537
Provider NameJeffrey Blake Gleick
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1760487599
PECOS PAC ID: 6406819754
Enrollment ID: I20041129000581
Provider NameEdward A Hubach
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1821091331
PECOS PAC ID: 6800824780
Enrollment ID: I20050802000006
Provider NamePaul J Opsahl
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1619953742
PECOS PAC ID: 0042248932
Enrollment ID: I20050802000056
Provider NameJoni Marie Koren
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1154323368
PECOS PAC ID: 8022046911
Enrollment ID: I20050802000077
Provider NameBarbara A Bennett
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1003819525
PECOS PAC ID: 3375571268
Enrollment ID: I20050802000091
Provider NameJames R Fisco
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1245233766
PECOS PAC ID: 5294763199
Enrollment ID: I20050802000166
Provider NameLawrence G Ratcliff
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1376529214
PECOS PAC ID: 4082500814
Enrollment ID: I20050802000529
Provider NameRebecca T Cherry
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1285622043
PECOS PAC ID: 3577577055
Enrollment ID: I20060203000589
Provider NameHarold S Edmiston
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1881728905
PECOS PAC ID: 8921196932
Enrollment ID: I20071108000389
Provider NameSara J Whitlock
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1710153556
PECOS PAC ID: 8123161734
Enrollment ID: I20100204000542
Provider NameLori B Milliron
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1043410830
PECOS PAC ID: 6305018268
Enrollment ID: I20111019000145
Provider NameDarin L Green
Provider TypePractitioner - Colorectal Surgery (proctology)
Provider IdentifiersNPI Number: 1811043664
PECOS PAC ID: 6103098488
Enrollment ID: I20120217000034
Provider NameChristopher Link
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1154682706
PECOS PAC ID: 2264697309
Enrollment ID: I20120622000461
Provider NameCorey A Davis
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1285071399
PECOS PAC ID: 6608017546
Enrollment ID: I20130718000766
Provider NameWilliam Venanzi
Provider TypePractitioner - Rheumatology
Provider IdentifiersNPI Number: 1174505937
PECOS PAC ID: 6507094638
Enrollment ID: I20140116000756
Provider NameKevin A Carter
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1053403329
PECOS PAC ID: 0941372551
Enrollment ID: I20140501001286
Provider NameStephanie A Beeching
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1275953002
PECOS PAC ID: 9739303991
Enrollment ID: I20140610001880
Provider NameKristen M Van Staalduinen
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1578010740
PECOS PAC ID: 4183912843
Enrollment ID: I20161012001017
Provider NameCaitlyn Frantz
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1487181574
PECOS PAC ID: 7719255728
Enrollment ID: I20170615002432
Provider NameKrista A Miller
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1093215089
PECOS PAC ID: 6709773658
Enrollment ID: I20180321002556
Provider NameTimothy D Webb
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1154721645
PECOS PAC ID: 1254628704
Enrollment ID: I20180626003681
Provider NameElissa Marie Reed
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1588141808
PECOS PAC ID: 4789933300
Enrollment ID: I20180815001699
Provider NameRian Kyles-stewart
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1114407061
PECOS PAC ID: 5294086476
Enrollment ID: I20180927000926
Provider NameAnn Marie Smith
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1700341294
PECOS PAC ID: 4688914120
Enrollment ID: I20190320002483
Provider NameAndrea Marion Malson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1073012423
PECOS PAC ID: 2466789383
Enrollment ID: I20190814003158
Provider NameAmy L. Goff-yates
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306407101
PECOS PAC ID: 3971935735
Enrollment ID: I20191115001491
Provider NameInna L Bair
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1063076412
PECOS PAC ID: 1951706704
Enrollment ID: I20210817004033
Provider NameAntoinette Marie Johnson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1760153357
PECOS PAC ID: 2567850779
Enrollment ID: I20211020002034
Provider NameChelsea Ea Ferree
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1588231369
PECOS PAC ID: 9830587674
Enrollment ID: I20211027000889
Provider NameBethany Lynn Ratliff
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1558025684
PECOS PAC ID: 8426447392
Enrollment ID: I20211115001801
Provider NameDilfuza Makhmudova
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1972269132
PECOS PAC ID: 6901299254
Enrollment ID: I20220209000000
Provider NameSara Ann Farling
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1780343251
PECOS PAC ID: 6305237066
Enrollment ID: I20220210002071
Provider NameApril J Lenz
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1538731724
PECOS PAC ID: 6507250131
Enrollment ID: I20220224003002
Provider NameCarrie Adele Cain
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396402905
PECOS PAC ID: 0042699522
Enrollment ID: I20220614002742
Provider NameSherry Ann Howard
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1679206981
PECOS PAC ID: 8022490614
Enrollment ID: I20220728002711
Provider NameMichelle J Bailey
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1841940673
PECOS PAC ID: 1052793502
Enrollment ID: I20220801002005
Provider NameJennifer Goodin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1215687199
PECOS PAC ID: 1759378581
Enrollment ID: I20220816000568

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Providence Medical Group is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Providence Medical Group
2912 Springboro Rd W, Suite 201,
Dayton, OH 45439-1674

Ph: (937) 297-8999		Providence Medical Group
2912 Springboro Rd W, Suite 201,
Dayton, OH 45439-1674

Ph: (937) 297-8999

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.