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DR. PAUL J OPSAHL MD
NPI 1619953742
Family Medicine in Waynesville, OH

Active since December 20, 2005PECOS EnrolledAccepts Medicare AssignmentCLIA 36D0699391 · Microscopy
4353 E STATE ROUTE 73 STE 120, WAYNESVILLE, OH 45068(513) 897-0085(513) 897-0194 Get Directions Write a Review

NPPES record last updated: July 24, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Paul J Opsahl Md NPPES

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

DR. PAUL J OPSAHL MD (NPI 1619953742) is an individual family medicine provider in Waynesville, Ohio, licensed in Ohio (35047593) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, holds a CLIA Microscopy certificate valid through April 26, 2028, and is affiliated with Miami Valley Hospital.

NPPES Registry Identity

NPI1619953742
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. PAUL J OPSAHLCredential: MD
Location Address4353 E STATE ROUTE 73 STE 120Waynesville, OH 45068-8814
Mailing Address2912 Springboro W, Suite 201Dayton, OH 45439-1674 · (513) 897-0085 · Fax (513) 897-0194
Phone(513) 897-0085
Fax(513) 897-0194
Sole ProprietorNo
Medical School CMSUniversity Of Cincinnati College Of MedicineGraduated 1981
Enumeration DateDecember 20, 2005
Last NPPES UpdateJuly 24, 2024
NPPES CertifiedJuly 24, 2024
✔ NPI 1619953742 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in OH · 35047593
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4353 E STATE ROUTE 73 STE 120, Waynesville, OH 45068
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Other Identifiers 10

Other000000227901OH · Unicare
Other080188829OH · Railroad Medicare
Other35047593Medical License
Medicaid0527497OH
Other421534506034OH · Caresource
Other634298ND · Aetna
OtherOC05219OH · Nationwide
Other0120625ND · United Health Care
Other000000227901OH · Anthem
Other4759302OH · Humana/choicecare

Accepted Insurance

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

Dr. Paul J Opsahl 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 ID42248932
PECOS Enrollment IDI20050802000056
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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 36D0699391

Paul J Opsahl MD · Waynesville, OH
Active · expires Apr 26, 2028
CLIA Number36D0699391
Laboratory TypePhysician Office
Certificate Effective DateApril 27, 2026
Certificate Expiration DateApril 26, 2028
Laboratory DirectorPaul J. Opsahl
Laboratory Phone(513) 897-0085
Laboratory LocationPaul J Opsahl MD4353 St Rte 73, Waynesville, OH 45068
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Areas of Expertise CMS Part B claims 5

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 moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
160 services113 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
86 services67 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
83 services83 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
45 services45 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
43 services43 patients

Hospital Affiliations CMS Care Compare 5

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

Miami Valley Hospital

Acute Care Hospitals · Dayton, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360051
LocationOne Wyoming StreetDayton, OH 45409 · Montgomery County
Emergency services Birthing friendly

Kettering Health Main Campus

Acute Care Hospitals · Kettering, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number360079
Location3535 Southern BoulevardKettering, OH 45429 · Montgomery County
Emergency services Birthing friendly

Kettering Health Dayton

Acute Care Hospitals · Dayton, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number360133
Location405 Grand AvenueDayton, OH 45405 · Montgomery County
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

Kettering Health Miamisburg

Acute Care Hospitals · Miamisburg, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number360239
Location4000 Miamisburg-Centerville RoadMiamisburg, OH 45342 · Montgomery County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45068 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.

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.

Reported Quality Measures

Adult Sinusitis: Antibiotic Prescribed for Acute Viral Sinusitis (Overuse)
Lower rates are better for this measure.
78%23 patients1/55-star benchmark: 100%
Appropriate Treatment for Upper Respiratory Infection (URI)
62%42 patients3/55-star benchmark: 100%
Breast Cancer Screening
60%330 patients3/55-star benchmark: 93%
Cervical Cancer Screening
19%335 patients1/55-star benchmark: 98%
Chlamydia Screening for Women
0%50 patients
Closing the Referral Loop: Receipt of Specialist Report
42%353 patients2/55-star benchmark: 87%
Colorectal Cancer Screening
52%837 patients3/55-star benchmark: 88%
Controlling High Blood Pressure
91%651 patients5/55-star benchmark: 91%
Diabetes: Eye Exam
8%200 patients1/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
15%200 patients4/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
79%3,377 patients3/55-star benchmark: 100%
e-Prescribing
100%1,357 patients5/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
5%613 patients1/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
58%1,477 patients3/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
47%904 patients2/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients screened: 4% · 1,305 patients
3%1,305 patients
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Patients screened: 8% · 971 patients
8%971 patients
Provide Patients Electronic Access to Their Health Information
76%716 patients3/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
83%452 patients4/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 2% · 574 patients
Patients totalRate: 14% · 637 patients
16%637 patients3/55-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.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
7 suppliers23 claims71 services$5.76 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers17 claims17 services$13.37 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers18 claims18 services$61.27 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
1 supplier14 claims14 services$14.46 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
4 suppliers21 claims21 services$202.62 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Paul Opsahl's NPI number?

The NPI number for Paul Opsahl is 1619953742. It was assigned to this individual provider in the NPPES registry on December 20, 2005.

Where is Paul Opsahl located?

Paul Opsahl practices at 4353 E State Route 73 Ste 120, Waynesville, OH 45068. The listed phone number is (513) 897-0085.

What is Paul Opsahl's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Paul Opsahl enrolled in Medicare?

Yes. Paul Opsahl 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.

Does Paul Opsahl hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 36D0699391) is associated with this NPI, valid through April 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Paul Opsahl accept?

Health plans from CareSource and UnitedHealthcare list Paul Opsahl 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 Paul Opsahl affiliated with any hospitals?

According to CMS data, Paul Opsahl is affiliated with Miami Valley Hospital, Kettering Health Main Campus, Kettering Health Dayton, Bethesda North and Kettering Health Miamisburg.

When was this NPI record last updated?

The NPPES record for Paul Opsahl was last updated on July 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.