DR. CRAIG ALAN PLOWGIAN M.D.
NPI 1154595973
Pediatrics in Cincinnati, OH

NPI Status: Active since April 14, 2008

Contact Information

559 OLD STATE ROUTE 74
CINCINNATI, OH
ZIP 45244
Phone: (513) 753-2820
Fax: (513) 753-2824

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  • Individual
  • Male
  • Pediatrics
  • Accepts Insurance

About CRAIG PLOWGIAN

This page provides the complete NPI Profile along with additional information for Craig Plowgian, a pediatrician established in Cincinnati, Ohio with a medical specialization in Pediatrics. The healthcare provider is registered in the NPI registry with number 1154595973 assigned on April 2008. The practitioner's primary taxonomy code is 208000000X with license number 35.094947 (OH). The provider is registered as an individual and his NPI record was last updated 13 years ago.

NPI
1154595973
Provider Name
DR. CRAIG ALAN PLOWGIAN M.D.
Gender
Male
Entity Type
Individual
Location Address
559 OLD STATE ROUTE 74 CINCINNATI, OH 45244
Location Phone
(513) 753-2820
Location Fax
(513) 753-2824
Mailing Address
5400 DUPONT CIRCLE SUITE A MILFORD, OH 45150
Mailing Phone
(513) 576-7700
Mailing Fax
(513) 753-2824
Is Sole Proprietor?
No
Enumeration Date
04-14-2008
Last Update Date
08-13-2013
Code Navigator

A pediatrician like Craig Plowgian is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pediatrics

Taxonomy Code
208000000X
Type
Allopathic & Osteopathic Physicians
License No.
35.094947
License State
OH
Taxonomy Description
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1208000000XAllopathic & Osteopathic Physicians

Pediatrics

57013786 (OH)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Pathway 10600 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway 10600 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway 8500 for HSA - HMO
  • Anthem Gold Pathway 2000 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Heart Healthy Bronze Pathway 6000 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Heart Healthy Silver Pathway 5000 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Silver Pathway 4000 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Silver Pathway 4000 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Silver Pathway 5500 for HSA - HMO
  • Anthem Silver Pathway 6000 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Bronze 7500 $25 Generic Drugs - HMO
  • Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Core Gold 1500 $10 Generic Drugs - HMO
  • Core Gold 1500 $10 Generic Drugs + Adult Vision & Fitness - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Gold 2000 $15 Generic Drugs - HMO
  • Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
  • HDHP Preventive Silver 5500 $0 Chronic Care Drugs - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Low Premium Silver 6200 $3 Generic Drugs - HMO
  • Low Premium Silver 6200 $3 Generic Drugs + Adult Vision & Fitness - HMO
  • Silver 6000 $20 Generic Drugs - HMO
  • Bronze Classic 4700 - HMO
  • Bronze Classic Standard - HMO
  • Bronze Elite + PCP Saver Plus - HMO
  • Bronze Simple Breathe Easy with Enhanced COPD Benefits - HMO
  • Bronze Simple Chronic Care CKM - HMO
  • Bronze Simple Diabetes - HMO
  • Gold Classic - HMO
  • Gold Classic Standard - HMO
  • Gold Elite Saver Plus - HMO
  • Silver Classic Standard - HMO
  • Silver Elite Saver Plus - HMO
  • Silver Simple Breathe Easy with Enhanced COPD Benefits - HMO
  • Silver Simple Chronic Care CKM - HMO
  • Silver Simple Diabetes - HMO
  • Silver Simple PCP Saver - HMO
  • Silver Simple Women's Health with Menopause Benefits - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
3090257MEDICAID (05)OH 
H187020MEDICARE PIN (08)OH 

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1154595973, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
4
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
9
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
9
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 5 → 10 → 1 5 → 10 → 1 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 0 + 4 + 1 + 0 + 9 + 1 + 0 + 9 + 1 + 4 + 24 = 57

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1154595973.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Pediatrics
559 OLD STATE ROUTE 74
CINCINNATI, OH 45244
Pediatrics
559 OLD STATE ROUTE 74
CINCINNATI, OH 45244

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1154595973, enumerated as an "individual" on April 14, 2008.

The provider is located at 559 OLD STATE ROUTE 74 CINCINNATI, OH 45244 and the phone number is (513) 753-2820.

Pediatrics with taxonomy code 208000000X.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, CareSource,. Please consult your insurance carrier or call the provider to verify.