DR. STACEY ISHMAN (M.D.) – Pediatric Otolaryngology Physician, NPI 1245287101
Pediatric Otolaryngology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. STACEY ISHMAN (M.D.)
3333 BURNET AVE ML 2018
CINCINNATI, OH 452293026
Phone: (513) 636-4355
Fax: (513) 636-8133
Type: Mailing
PO BOX 933432
CLEVELAND, OH 441930039
Phone: (937) 641-5072
Fax: (937) 641-6129
Type: Mailing
1675 Highland Ave
Madison, WI 537923026
Phone: (608) 263-6420
Type: Location
8402 HARCOURT RD STE 400
INDIANAPOLIS, IN 462602053
Phone: (317) 338-6815
Type: Location
Cincinnati Children’s Hospital Medical Center, 3333, Burnet Avenue, Pill Hill, Corryville, Cincinnati, Hamilton County, Ohio, 45229-3026, United States
ML 2018
CINCINNATI, OH 452293026
Phone: (513) 636-4355
Fax: (513) 636-8133
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $1,629.
Total Amount is formed as General ($1,629) + Research ($0) + Ownership ($0) = $1,629.
Last reported payment date: 2024-12-10 • Largest payer in this snapshot: Ethicon Inc. ($1,110).
Total Amount
$1,629
General + Research + Ownership
Payments
7
Total payment records
General Amount
$1,629
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Ethicon Inc. | $1,110 |
| Inspire Medical Systems, Inc. | $519 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-06-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220914001701 | I | Otolaryngology | IL | TBD |
| I20221104001173 | I | Otolaryngology | IN | TBD |
| I20230613001878 | I | Otolaryngology | WI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 45229)
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Group practice members
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