JUSTINE HOLTHAUS – Psychiatric/Mental Health Nurse Practitioner, NPI 1316412174
Psychiatric/Mental Health Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
14,989 NURSE PRACTITIONER in OH
Provider Addresses for JUSTINE HOLTHAUS
4100 W 3rd St
Dayton, OH 454289000
Phone: (937) 268-6511
Type: Location
4100, West 3rd Street, Residence Park, Dayton, Montgomery County, Ohio, 45417, United States
DAYTON, OH 454289000
Phone:
Type: Mailing
1 PRESTIGE PL STE 550
MIAMISBURG, OH 453426115
Phone: (937) 762-1310
Fax: (937) 522-8068
Type: Mailing
6147 STATE ROUTE 122 STE 200
MIDDLETOWN, OH 450055201
Phone: (937) 490-2090
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2020-09-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20200901003026 | I | Nurse Practitioner | OH | 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 45428)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | OH | |
| Radiation Oncology | OH | |
| O B S T E T R I C S/ G Y N E C O L O G Y | OH | |
| Orthopedic Surgery | OH | |
| Physician Assistant | OH | |
| Physician Assistant | OH | |
| O B S T E T R I C S/ G Y N E C O L O G Y | OH | |
| Nurse Practitioner | OH | |
| Vascular Surgery | OH | |
| Registered Dietitian Or Nutrition Professional | OH |
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