DR. JOHN A SHRADER (MD) – Internal Medicine Physician, NPI 1902887086

DR. JOHN A SHRADER (MD) is a healthcare provider. based in Miamisburg, Ohio. specializing in INTERNAL MEDICINE. They hold the professional credentials MD. They hold a License No. 35 046802 (OH). The NPI Number for DR. JOHN A SHRADER (MD) is 1902887086

Main info

Male
Sole Proprietor
46 Years Of Experience
Accepts Medicare Assignment
Name
DR. JOHN A SHRADER (MD)
NPI
1902887086
Phone
(937) 384-6800
Address
2115 LEITER RD
Enumeration Date
7 November 2005
Last Update Date
6 April 2022

Doctor Profile

Medical School Name
LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
9373846920
Graduation Year
1980 (46 years ago)
PAC ID
2264576073
Group Practice PAC ID
0840104360
Professional Enrollment ID
I20100217000543
Address ID
OH453423600MI2115XRDXX300

Contacts

Secure Messaging
jshrader197413@direct.ketteringhealth.org
FHIR Endpoint
https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

7,199 INTERNAL MEDICINE in OH

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Provider Addresses for DR. JOHN A SHRADER (MD)

  • 2115, Leiter Road, Miamisburg, Montgomery County, Ohio, 45342, United States

    MIAMISBURG, OH 453423659

    Phone: (937) 384-6800

    Fax: (937) 384-6939

    Mailing address matches the actual address.

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: 2010-02-17

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
I20100217000543IInternal MedicineOHTBD

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 45342)

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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: 0840104360View full group profile

Reviews

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Frequently asked questions

Can I verify DR. JOHN A SHRADER (MD) with an NPI only?
You can start verification with NPI 1902887086 for DR. JOHN A SHRADER (MD), then check state licensing separately.
Can I rely on DR. JOHN A SHRADER (MD) being an active provider?
As of the registry snapshot, DR. JOHN A SHRADER (MD) is marked active.
What is DR. JOHN A SHRADER (MD)'s specialty?
The listing groups DR. JOHN A SHRADER (MD) with Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Does DR. JOHN A SHRADER (MD) list a practice location?
Patients near Miamisburg, Ohio may find DR. JOHN A SHRADER (MD) in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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