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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. JOHN P DETHERAGE III MD
NPI 1447833504
Emergency Medicine - Sports Medicine in Cincinnati, OH

Active since May 05, 2021PECOS EnrolledAccepts Medicare Assignment
7910 BEECHMONT AVE, CINCINNATI, OH 45255(513) 232-2663(513) 605-1622 Get Directions Write a Review

NPPES record last updated: October 14, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 14, 2026, Nov 3, 2025, Jun 30, 2025 and 2 more (5 updates tracked since 2021).

About Dr. John P Detherage Iii Md NPPES

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

DR. JOHN P DETHERAGE III MD (NPI 1447833504) is an individual sports medicine provider in Cincinnati, Ohio, licensed in Ohio (35150486) and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS, is affiliated with Mccullough-hyde Memorial Hospital, and maintains a secondary practice location in Montgomery.

NPPES Registry Identity

NPI1447833504
Entity TypeIndividualMale
Primary Taxonomy207PS0010X
Provider Legal NameDR. JOHN P DETHERAGE IIICredential: MD
Location Address7910 BEECHMONT AVECincinnati, OH 45255-4210
Mailing Address560 S Loop RdEdgewood, KY 41017-3405
Phone(513) 232-2663
Fax(513) 605-1622
Sole ProprietorNo
Medical School CMSWright State University Boonshoft School Of MedicineGraduated 2021
Enumeration DateMay 5, 2021
Last NPPES UpdateOctober 14, 20265 updates tracked since enumeration
NPPES CertifiedOctober 14, 2026
✔ NPI 1447833504 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207PS0010X
Licenses✔ Licensed in OH · 35150486✔ Licensed in IN · 01098271A✔ Licensed in KY · 59124
Definition
An emergency physician with special knowledge in sports medicine is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention and management of injury and illness. A sports medicine physician has knowledge and experience in the promotion of wellness and the role of exercise in promoting a healthy lifestyle. Knowledge of exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation and epidemiology is essential to the practice of sports medicine.
Also ListedEmergency MedicineTaxonomy 207P00000X · License 35150486 (OH), 59124 (KY), 01098271A (IN)
7910 BEECHMONT AVE, Cincinnati, OH 45255
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Secondary Practice Location 1

Location 110506 Montgomery Rd Ste 209Montgomery, OH 45242-4400 · Phone (513) 865-9040

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. John P Detherage Iii 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 ID1355792763
PECOS Enrollment IDI20240828003117, I20251113002322, I20260107002994
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.

Medicare Billing Reassignments

3

Medicare enrollment records show John Detherage reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Of Cincinnati Physicians Company, LLC
10.0 mi
Family Medicine
3188 BELLEVUE AVE
Cincinnati, OH 45219
  • Reassigned Medicare billing, Ohio enrollment
  • 2,038 clinicians in this Medicare group
NPI 1801840434 (513) 584-1000
Qualified Emergency Specialists Inc
12 mi
Emergency Medicine
10500 MONTGOMERY RD
Montgomery, OH 45242
  • Reassigned Medicare billing, Ohio enrollment
  • 119 clinicians in this Medicare group
NPI 1700872728 (513) 865-1307
Orthocincy Orthopaedics & Sports Medicine Psc
13 mi
Orthopaedic Surgery
560 S LOOP RD
Edgewood, KY 41017
  • Reassigned Medicare billing, Indiana, Kentucky and Ohio enrollments
  • 26 clinicians in this Medicare group
NPI 1598714560 (859) 301-2663

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

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.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
34 services34 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
15 services15 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
13 services13 patients

Hospital Affiliations CMS Care Compare 3

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

Mccullough-Hyde Memorial Hospital

Acute Care Hospitals · Oxford, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360046
Location110 North Poplar StreetOxford, OH 45056 · Butler County
Emergency services Birthing friendly

Good Samaritan Hospital

Acute Care Hospitals · Cincinnati, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360134
Location375 Dixmyth AvenueCincinnati, OH 45220 · Hamilton County
Emergency services Birthing friendly

Bethesda North

Acute Care Hospitals · Cincinnati, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number360179
Location10500 Montgomery RoadCincinnati, OH 45242 · Hamilton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45255 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
$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.

Other Providers at the Same Location NPPES 20

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

MACAIRA ROONEY BOBINGER DPT
Physical Therapist
7910 BEECHMONT AVE
CINCINNATI, OH 45255
Hamilton County (513) 232-2663
LEAH MARIE TILTON PA-C
Physician Assistant
7910 BEECHMONT AVE
CINCINNATI, OH 45255
Hamilton County (513) 232-2663
KELLY MARIE PITZER PA-C
Physician Assistant (Surgical)
7910 BEECHMONT AVE
CINCINNATI, OH 45255
Hamilton County (513) 232-2663
DR. FRANCIS CLIFFORD VALENTIN M.D.
Physical Medicine & Rehabilitation
7910 BEECHMONT AVE
CINCINNATI, OH 45255
Hamilton County (513) 232-2663
DR. ARTHUR FRANCIS LEE MD
Orthopaedic Surgery
7910 BEECHMONT AVE
CINCINNATI, OH 45255
Hamilton County (513) 232-2663
DR. BRAD ROBERT WENSTRUP D.P.M.
Podiatrist
7910 BEECHMONT AVE
CINCINNATI, OH 45255
Hamilton County (513) 232-2663
PAIGE ELIZABETH DEWITT PT
Physical Therapist
7910 BEECHMONT AVE
CINCINNATI, OH 45255
Hamilton County (513) 232-2663
VICTORIA CANNING DPT
Physical Therapist
7910 BEECHMONT AVE
CINCINNATI, OH 45255
Hamilton County (513) 232-2663

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 Detherage's NPI number?

The NPI number for John Detherage is 1447833504. It was assigned to this individual provider in the NPPES registry on May 5, 2021.

Where is John Detherage located?

John Detherage practices at 7910 Beechmont Ave, Cincinnati, OH 45255. The listed phone number is (513) 232-2663.

What is John Detherage's specialty?

The primary specialty registered for this NPI is Emergency Medicine, specializing in Sports Medicine, with taxonomy code 207PS0010X.

Is John Detherage enrolled in Medicare?

Yes. John Detherage 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.

Which organizations bill Medicare for John Detherage's services?

According to the CMS Revalidation Reassignment List (October 2026 release), John Detherage reassigns Medicare benefits to 3 organizations: University Of Cincinnati Physicians Company, LLC (Cincinnati, OH), Qualified Emergency Specialists Inc (Montgomery, OH) and Orthocincy Orthopaedics & Sports Medicine Psc (Edgewood, KY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for John Detherage's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does John Detherage accept?

Health plans from CareSource list John Detherage 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 Detherage affiliated with any hospitals?

According to CMS data, John Detherage is affiliated with Mccullough-Hyde Memorial Hospital, Good Samaritan Hospital and Bethesda North.

When was this NPI record last updated?

The NPPES record for John Detherage was last updated on October 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 days 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.