JUSTIN NEILL (M.D.) – Family Medicine Physician, NPI 1609188432

JUSTIN NEILL (M.D.) is a healthcare provider. based in Kettering, Ohio. specializing in Family Medicine Physician. They hold the professional credentials M.D.. They hold a License No. 0116024153 (VA). The NPI Number for JUSTIN NEILL (M.D.) is 1609188432

Main info

Male
17 Years Of Experience
Accepts Medicare Assignment
Name
JUSTIN NEILL (M.D.)
NPI
1609188432
Phone
(800) 875-0136
Address
4750 HEMPSTEAD STATION DR
Enumeration Date
9 July 2010
Last Update Date
28 August 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9372083356
Graduation Year
2009 (17 years ago)
PAC ID
5496999211
Group Practice PAC ID
9537064183
Professional Enrollment ID
I20130918000208
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience58
Completeness75
Years active:15State licenses:2Digital endpointsOther names

Provider Addresses for JUSTIN NEILL (M.D.)

  • 4750 HEMPSTEAD STATION DR

    KETTERING, OH 454295164

    Phone: (800) 875-0136

    Fax: (937) 619-4150

    Type: Location

  • 1 MEDICAL CENTER DR

    MIDDLETOWN, OH 450052584

    Phone: (513) 420-5017

    Fax: (937) 619-4150

    Type: Mailing

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: 2013-09-18

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20130918000208IFamily PracticeOHTBD

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.

Verify on CMS Revalidation Lookup Tool

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 45429)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9537064183View full group profile

Reviews

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Frequently asked questions

What is the 10-digit NPI for JUSTIN NEILL (M.D.)?
JUSTIN NEILL (M.D.) — NPI 1609188432 — is the standard way to identify this listing.
Is JUSTIN NEILL (M.D.) still practicing?
JUSTIN NEILL (M.D.) is currently listed as active in the public NPI registry.
What is JUSTIN NEILL (M.D.) best known for clinically?
Directory data describes JUSTIN NEILL (M.D.) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where is JUSTIN NEILL (M.D.) based?
JUSTIN NEILL (M.D.) is tied to Kettering, Ohio in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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