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DR. ANTHONY F GUANCIALE M.D.
NPI 1205884822
Orthopaedic Surgery in Cincinnati, OH

Active since May 05, 2006PECOS Enrolled
78.78/100
CMS Quality Rating
9250 BLUE ASH RD, CINCINNATI, OH 45242(513) 792-7445(513) 791-4042 Get Directions Write a Review

NPPES record last updated: December 5, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 5, 2017, Sep 30, 2015 (2 updates tracked since 2015).

About Dr. Anthony F Guanciale M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ANTHONY F GUANCIALE M.D. (NPI 1205884822) is an individual orthopaedic surgery provider in Cincinnati, Ohio, licensed in Ohio (35.062680) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205884822
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. ANTHONY F GUANCIALECredential: M.D.
Location Address9250 BLUE ASH RDCincinnati, OH 45242
Mailing AddressPo Box 636256 Po Box 636256Cincinnati, OH 45263-6256 · (513) 585-5506 · Fax (513) 585-5511
Phone(513) 792-7445
Fax(513) 791-4042
Sole ProprietorNo
Enumeration DateMay 5, 2006
Last NPPES UpdateDecember 5, 20172 updates tracked since enumeration
✔ NPI 1205884822 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
Licenses✔ Licensed in OH · 35.062680✔ Licensed in OH · 35062680G
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Also ListedOrthopaedic Surgery · Orthopaedic Surgery of the SpineTaxonomy 207XS0117X · License 3506280G (OH)
9250 BLUE ASH RD, Cincinnati, OH 45242
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Other Identifiers 6

Medicaid162201OH
Medicaid64939127KY
OtherH164280OH · Medicare
Medicaid200051170IN
Medicaid0162201OH
Other200024475OH · Railroad Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Anthony F Guanciale M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
66 services49 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45242 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.10 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

78.78/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality70.42
Promoting Interoperability100
Improvement Activities40
Cost58.86

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MICHAEL J KRAMER M.D.
Neurological Surgery
9250 BLUE ASH RD
CINCINNATI, OH 45242
Hamilton County (513) 792-7445
RACHEL LOUISE HEBERLING MD
Physical Medicine & Rehabilitation
9250 BLUE ASH RD
BLUE ASH, OH 45242
Hamilton County (513) 792-7445
MR. DAVID M BRODBECK PA-C
Physician Assistant (Surgical)
9250 BLUE ASH RD
CINCINNATI, OH 45242
Hamilton County (513) 792-7445
MARC C SCHNEIDER M.D.
Orthopaedic Surgery
9250 BLUE ASH RD
BLUE ASH, OH 45242
Hamilton County (513) 792-6550
NICHOLAS GODBY
Physical Medicine & Rehabilitation
9250 BLUE ASH RD
BLUE ASH, OH 45242
Hamilton County (513) 792-7441
EBEN DE MATTEO PA-C
Physician Assistant
9250 BLUE ASH RD
BLUE ASH, OH 45242
Hamilton County (513) 792-7445
DOUGLAS J MONTGOMERY PA-C
Physician Assistant (Surgical)
9250 BLUE ASH RD
CINCINNATI, OH 45242
Hamilton County (513) 792-7445
ALFRED KAHN III M.D.
Orthopaedic Surgery
9250 BLUE ASH RD
CINCINNATI, OH 45242
Hamilton County (513) 792-7445

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Anthony Guanciale's NPI number?

The NPI number for Anthony Guanciale is 1205884822. It was assigned to this individual provider in the NPPES registry on May 5, 2006.

Where is Anthony Guanciale located?

Anthony Guanciale practices at 9250 Blue Ash Rd, Cincinnati, OH 45242. The listed phone number is (513) 792-7445.

What is Anthony Guanciale's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Anthony Guanciale enrolled in Medicare?

Yes. Anthony Guanciale is registered in the Medicare PECOS enrollment system.

What insurance does Anthony Guanciale accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 2 other insurers list Anthony Guanciale as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Anthony Guanciale was last updated on December 5, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.