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MICAH SCHMAL DO
NPI 1861923575
Family Medicine in Hamilton, OH

Active since March 23, 2017PECOS EnrolledAccepts Medicare Assignment
1391 MAIN ST, HAMILTON, OH 45013(513) 867-9000(513) 785-3675 Get Directions Write a Review

NPPES record last updated: November 26, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 3, 2021, Jun 29, 2021, Jun 23, 2020 and 1 more (4 updates tracked since 2017).

About Micah Schmal Do NPPES

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

MICAH SCHMAL DO (NPI 1861923575) is an individual family medicine provider in Hamilton, Ohio, licensed in Ohio (34.015230) and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS, is affiliated with Mercy Health - Fairfield Hospital, and is a graduate of Edward Via Col Of Osteo Medicine-carolinas Campus (2017).

NPPES Registry Identity

NPI1861923575
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameMICAH SCHMALCredential: DO
Location Address1391 MAIN STHamilton, OH 45013-1077
Mailing Address1 Prestige Pl Ste 550Miamisburg, OH 45342-6115 · (937) 762-1310 · Fax (937) 522-8068
Phone(513) 867-9000
Fax(513) 785-3675
Sole ProprietorNo
Medical School CMSEdward Via Col Of Osteo Medicine-carolinas CampusGraduated 2017
Enumeration DateMarch 23, 2017
Last NPPES UpdateNovember 26, 20244 updates tracked since enumeration
NPPES CertifiedNovember 26, 2024
✔ NPI 1861923575 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in OH · 34.015230
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.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License OT020385 (PA)
1391 MAIN ST, Hamilton, OH 45013
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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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Micah Schmal Do 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 ID42583338
PECOS Enrollment IDI20210706003526
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 Reassignment

Medicare enrollment records show Micah Schmal reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Alliance Physicians, Inc.
0.2 mi
Urgent Care
1 N BROOKWOOD AVE
Hamilton, OH 45013
  • Reassigned Medicare billing, Ohio enrollment
  • 364 clinicians in this Medicare group
NPI 1366713042 (513) 896-9700

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 8

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.
255 services157 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.
118 services79 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.
116 services116 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
57 services43 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.
47 services46 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
43 services42 patients

Hospital Affiliations CMS Care Compare 2

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

Mercy Health - Fairfield Hospital

Acute Care Hospitals · Fairfield, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360056
Location3000 Mack RoadFairfield, OH 45014 · Butler County
Emergency services Birthing friendly

Fort Hamilton Hughes Memorial Hospital

Acute Care Hospitals · Hamilton, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360132
Location630 Eaton AvenueHamilton, OH 45013 · Butler County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45013 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 3

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

DR. SHANTHI RAJARATNAM M.D.
Family Medicine
1391 MAIN ST
HAMILTON, OH 45013
Butler County (513) 867-9000
MRS. HANNAH JOY CARR PA-C
Physician Assistant
1391 MAIN ST
HAMILTON, OH 45013
Butler County (513) 867-9000
MS. SHARI LYNN GABBARD CNP
Nurse Practitioner (Family)
1391 MAIN ST
HAMILTON, OH 45013
Butler County (513) 867-9000

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 Micah Schmal's NPI number?

The NPI number for Micah Schmal is 1861923575. It was assigned to this individual provider in the NPPES registry on March 23, 2017.

Where is Micah Schmal located?

Micah Schmal practices at 1391 Main St, Hamilton, OH 45013. The listed phone number is (513) 867-9000.

What is Micah Schmal's specialty?

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

Is Micah Schmal enrolled in Medicare?

Yes. Micah Schmal 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 organization bills Medicare for Micah Schmal's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Micah Schmal reassigns Medicare benefits to Alliance Physicians, Inc. (Hamilton, OH). The 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 Micah Schmal's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Micah Schmal accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 4 other insurers list Micah Schmal 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 Micah Schmal affiliated with any hospitals?

According to CMS data, Micah Schmal is affiliated with Mercy Health - Fairfield Hospital and Fort Hamilton Hughes Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Micah Schmal was last updated on November 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.