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JOHN R LOUGHREY MD
NPI 1437120706
Internal Medicine - Gastroenterology in Cincinnati, OH

Active since January 27, 2006PECOS EnrolledAccepts Medicare Assignment
78.78/100
CMS Quality Rating
5215 N BEND RD, CINCINNATI, OH 45247(513) 681-8800(513) 681-6999 Get Directions Write a Review

NPPES record last updated: March 20, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About John R Loughrey Md NPPES

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

JOHN R LOUGHREY MD (NPI 1437120706) is an individual gastroenterology provider in Cincinnati, Ohio, licensed in Ohio (33596) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, is affiliated with West Chester Hospital, and is a graduate of University Of Cincinnati College Of Medicine (1971).

NPPES Registry Identity

NPI1437120706
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameJOHN R LOUGHREYCredential: MD
Location Address5215 N BEND RDCincinnati, OH 45247-8006
Mailing AddressPo Box 632551Cincinnati, OH 45263-2551 · (513) 681-8800 · Fax (513) 681-6999
Phone(513) 681-8800
Fax(513) 681-6999
Sole ProprietorYes
Medical School CMSUniversity Of Cincinnati College Of MedicineGraduated 1971
Enumeration DateJanuary 27, 2006
Last NPPES UpdateMarch 20, 2013
✔ NPI 1437120706 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in OH · 33596
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
5215 N BEND RD, Cincinnati, OH 45247
Open in Google Maps ↗

Other Identifiers 4

Medicaid0309884OH
Medicare PIN0397602OH
Other102530944OH · Medicare Railroad
Medicare UPINA74703OH

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 and accepts Medicare assignment

John R Loughrey Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2567358989
PECOS Enrollment IDI20040224000316
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.

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
66 services61 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
63 services44 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

West Chester Hospital

Acute Care Hospitals · West Chester, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360354
Location7700 University DriveWest Chester, OH 45069 · Butler County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45247 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
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
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

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
52%260 patients3/55-star benchmark: 85%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
8%48 patients1/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%546 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
98%730 patients4/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%552 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
100%401 patients5/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
7%194 patients1/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
24%398 patients2/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
56%401 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
2%401 patients1/55-star benchmark: 79%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 194 patients
1%194 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 3

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

DR. ARTHUR RANZ D.D.S.
Dentist
5215 N BEND RD
CINCINNATI, OH 45247
Hamilton County (513) 662-8003
DR. DERRICK H PECK DDS
Dentist (General Practice)
5215 N BEND RD
CINCINNATI, OH 45247
Hamilton County (513) 481-8051
ARTHUR J RANZ DDS INC
Clinic/Center (Dental)
5215 N BEND RD
CINCINNATI, OH 45247
Hamilton County (513) 662-8003

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 John Loughrey's NPI number?

The NPI number for John Loughrey is 1437120706. It was assigned to this individual provider in the NPPES registry on January 27, 2006.

Where is John Loughrey located?

John Loughrey practices at 5215 N Bend Rd, Cincinnati, OH 45247. The listed phone number is (513) 681-8800.

What is John Loughrey's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is John Loughrey enrolled in Medicare?

Yes. John Loughrey is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does John Loughrey accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 3 other insurers list John Loughrey 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.

Is John Loughrey affiliated with any hospitals?

According to CMS data, John Loughrey is affiliated with West Chester Hospital.

When was this NPI record last updated?

The NPPES record for John Loughrey was last updated on March 20, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.