KETTERING SPORTS MEDICINE
NPI 1821160243
Family Medicine - Sports Medicine in Kettering, OH

Q: What is Alliance Physician Inc's NPI number?

The NPI number for Alliance Physician Inc is 1821160243. It was assigned to this organization in the NPPES registry on November 14, 2006. The provider is doing business as Kettering Sports Medicine.

Q: What is Alliance Physician Inc's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Active since November 14, 2006

4403 FAR HILLS AVE, KETTERING, OH 45429(937) 395-3920(937) 395-3940 Get Directions Write a Review

NPPES record last updated: October 4, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 4, 2019, Dec 15, 2017 (2 updates tracked since 2017).

On this page

About Kettering Sports Medicine NPPES

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

KETTERING SPORTS MEDICINE (NPI 1821160243) is a healthcare organization registered as a sports medicine in Kettering, Ohio and active in the NPI registry since November 2006. The organization lists Timothy Y Ko, Cfo, as its authorized official.

NPPES Registry Identity

NPI1821160243

Entity TypeOrganization

Primary Taxonomy207QS0010X

Legal Business NameALLIANCE PHYSICIAN INC

Location Address4403 FAR HILLS AVEKettering, OH 45429-2405

Mailing Address1 Prestige Pl, Suite 550Miamisburg, OH 45342-3794 · (937) 762-1305 · Fax (937) 522-7513

Phone(937) 395-3920

Fax(937) 395-3940

Organization SubpartYesParent: Alliance Physicians, Inc

Authorized OfficialTimothy Y KoCfo · (937) 558-3223

Enumeration DateNovember 14, 2006

Last NPPES UpdateOctober 4, 20192 updates tracked since enumeration

✔ NPI 1821160243 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QS0010X

Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

4403 FAR HILLS AVE, Kettering, OH 45429

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Other Names 1

Doing Business AsKettering Sports Medicine

Other Identifiers 1

Medicaid2864833OH

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kettering Sports Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

363

Medicare enrollment records show 363 clinicians reassign Medicare billing to Kettering Sports Medicine, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 170 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 20

Family Practice169

Nurse Practitioner129

Internal Medicine35

Hospitalist4

Neurology4

Obstetrics/Gynecology4

Pediatric Medicine3

Psychiatry3

12 other specialties12

Nearest to this location (20)

See all 363

Patrick Asdell, M.D.

Family Practice

NPI 1063162337

4403 FAR HILLS AVE
Kettering, OH 45429

(937) 395-3900

✔ PECOS✔ Accepts MedicareSame address

Iman Bastawros, MD

Family Practice

NPI 1184677585

4441 FAR HILLS AVE
Kettering, OH 45429

(937) 298-7351

✔ PECOS✔ Accepts Medicare0.1 mi

Mary Kanoza, MD

Family Practice

NPI 1609194588

4441 FAR HILLS AVE
Kettering, OH 45429

(937) 298-7351

✔ PECOS✔ Accepts Medicare0.1 mi

Michelle Sturm, CNP

Nurse Practitioner

NPI 1164931929

4441 FAR HILLS AVE
Kettering, OH 45429

(937) 298-7351

✔ PECOS✔ Accepts Medicare0.1 mi

Eric Thuney, MD

Family Practice

NPI 1245684000

4441 FAR HILLS AVE
Dayton, OH 45429

(937) 298-7351

✔ PECOS✔ Accepts Medicare0.1 mi

John Thuney, MD

Family Practice

NPI 1215993415

4441 FAR HILLS AVE
Kettering, OH 45429

(937) 298-7351

✔ PECOS0.1 mi

Carrie Cain, CNP

Nurse Practitioner

NPI 1396402905

4441 FAR HILLS AVE
Kettering, OH 45429

(937) 298-7351

✔ PECOS✔ Accepts Medicare0.1 mi

Aelius Khan, MD

Family Practice

NPI 1194352799

4441 FAR HILLS AVE
Kettering, OH 45429

(937) 298-7351

✔ PECOS✔ Accepts Medicare0.1 mi

Joseph Mastandrea, D.O.

Internal Medicine

NPI 1649262924

4441 FAR HILLS AVE
Kettering, OH 45429

(937) 298-7351

✔ PECOS0.1 mi

Arvin Nanda, DO

Family Practice

NPI 1184624413

4441 FAR HILLS AVE
Kettering, OH 45429

(937) 298-7351

✔ PECOS✔ Accepts Medicare0.1 mi

Gretchen Polinski

Family Practice

NPI 1588195382

4441 FAR HILLS AVE
Kettering, OH 45429

(937) 298-7351

✔ PECOS✔ Accepts Medicare0.1 mi

Deshay Scandrick, CNP

Nurse Practitioner

NPI 1851531628

4441 FAR HILLS AVE
Kettering, OH 45429

(937) 298-7351

✔ PECOS✔ Accepts Medicare0.1 mi

Rena Kalter, FNP-BC

Nurse Practitioner

NPI 1629508494

424 E STROOP RD
Kettering, OH 45429

(937) 562-2300

✔ PECOS✔ Accepts Medicare0.4 mi

Olivia Aikman

Nurse Practitioner

NPI 1508480849

424 E STROOP RD UNIT B
Kettering, OH 45429

(937) 562-2300

✔ PECOS✔ Accepts Medicare0.8 mi

Penny Drazer, CNP

Nurse Practitioner

NPI 1598222127

540 LINCOLN PARK BLVD STE 200
Kettering, OH 45429

(937) 929-1117

✔ PECOS✔ Accepts Medicare0.9 mi

Malak Adib, MD

Internal Medicine

NPI 1679538557

500 LINCOLN PARK BLVD SUITE 110
Kettering, OH 45429

(937) 531-5020

✔ PECOS✔ Accepts Medicare1.0 mi

Pam Brokaw-Myers, NP

Nurse Practitioner

NPI 1467988790

500 LINCOLN PARK BLVD STE 110
Kettering, OH 45429

(937) 531-5020

✔ PECOS✔ Accepts Medicare1.0 mi

Peter Nelson

Internal Medicine

NPI 1457610784

500 LINCOLN PARK BLVD STE 110
Kettering, OH 45429

(937) 531-5020

✔ PECOS✔ Accepts Medicare1.0 mi

Randall Aybar, M.D.

Internal Medicine

NPI 1144351149

500 LINCOLN PARK BLVD STE 110
Kettering, OH 45429

(937) 531-5020

✔ PECOS✔ Accepts Medicare1.0 mi

John Mauer, MD

Internal Medicine

NPI 1407812829

540 LINCOLN PARK BLVD SUITE 200
Kettering, OH 45429

(937) 293-1117

✔ PECOS✔ Accepts Medicare1.0 mi

See all 363 clinicians

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

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 Alliance Physician Inc's NPI number?

The NPI number for Alliance Physician Inc is 1821160243. It was assigned to this organization in the NPPES registry on November 14, 2006. The provider is doing business as Kettering Sports Medicine.

Where is Alliance Physician Inc located?

Alliance Physician Inc is located at 4403 Far Hills Ave, Kettering, OH 45429. The listed phone number is (937) 395-3920.

What is Alliance Physician Inc's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Alliance Physician Inc enrolled in Medicare?

Yes. Alliance Physician Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Alliance Physician Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 363 clinicians in 20 Medicare specialties reassign their Medicare billing to Alliance Physician Inc. A 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 the clinician's services. The largest specialties are Family Practice (169), Nurse Practitioner (129) and Internal Medicine (35). Of these, 1 practice at this address and 170 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Alliance Physician Inc accept?

Health plans from Anthem Blue Cross and Blue Shield and CareSource list Alliance Physician Inc 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 Alliance Physician Inc was last updated on October 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.