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DR. PETER M PAVLINA MD
NPI 1881692341
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Kettering, OH

Active since July 08, 2005PECOS Enrolled
84.5/100
CMS Quality Rating
3533 SOUTHERN BLVD, STE 5650, KETTERING, OH 45429(937) 294-3611(937) 294-9010 Get Directions Write a Review

NPPES record last updated: January 6, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 6, 2021, Jan 23, 2019 (2 updates tracked since 2019).

About Dr. Peter M Pavlina Md NPPES

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

DR. PETER M PAVLINA MD (NPI 1881692341) is an individual thoracic surgery (cardiothoracic vascular surgery) provider in Kettering, Ohio, licensed in Ohio (35058244) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1881692341
Entity TypeIndividualMale
Primary Taxonomy208G00000X
Provider Legal NameDR. PETER M PAVLINACredential: MD
Location Address3533 SOUTHERN BLVD, STE 5650Kettering, OH 45429-1264
Mailing Address3533 Southern Blvd, Ste 5650Dayton, OH 45429-1264 · (937) 294-3611
Phone(937) 294-3611
Fax(937) 294-9010
Sole ProprietorNo
Enumeration DateJuly 8, 2005
Last NPPES UpdateJanuary 6, 20212 updates tracked since enumeration
NPPES CertifiedJanuary 6, 2021
✔ NPI 1881692341 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic Physicians
Taxonomy Code208G00000X
License✔ Licensed in OH · 35058244
Definition
A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
3533 SOUTHERN BLVD, Kettering, OH 45429
Open in Google Maps ↗

Other Identifiers 1

Medicaid0743039OH

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Peter M Pavlina Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Peter Pavlina reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kettering Independent Medical Group Inc
4.9 mi
Orthopaedic Surgery
1 PRESTIGE PL, SUITE 910
Miamisburg, OH 45342
  • Reassigned Medicare billing, Ohio enrollment
  • 984 clinicians in this Medicare group
NPI 1629387865 (937) 762-1629

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 4

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.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
26 services26 patients
Harvest of vein using an endoscope 33508
Harvesting a vein using an endoscope is a procedure where a small camera is used to help surgeons remove a vein from your body. This vein is often used to bypass a blocked artery, improving blood flow to your heart.
16 services16 patients
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.
16 services14 patients
Coronary artery bypass using artery graft, 1 graft 33533
A coronary artery bypass with one artery graft is a surgical procedure to improve blood flow to your heart. An artery from another part of your body is used to bypass a blocked or narrowed coronary artery. This can help reduce chest pain and risk of heart attack.
12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45429 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
$166.65 typical visit price
range $54.34 – $166.65
Typical copayment $41.66 (range $13.58 – $41.66)
Most-billed visit code 99205
Established Patient
$68.07 typical visit price
range $17.10 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
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.

84.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.16
Promoting Interoperability100
Improvement Activities40
Cost67.18

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.

DR. CAROL JOANNE SAWMILLER M.D.
Surgery
3533 SOUTHERN BLVD, SUITE 2250
KETTERING, OH 45429
Montgomery County (937) 534-0330
MIAMI VALLEY UROLOGY
Specialist
3533 SOUTHERN BLVD, STE 3450
KETTERING, OH 45429
Montgomery County (937) 293-0008
DR. JALEH ESLAMI M.D.
Plastic Surgery
3533 SOUTHERN BLVD, SUITE 4300
KETTERING, OH 45429
Montgomery County (937) 395-8454
CHRISTA SIEBENBURGEN M.D.
Surgery
3533 SOUTHERN BLVD, SUITE 2100
KETTERING, OH 45429
Montgomery County (937) 395-8556
DR. DAVID L TIBBITS M.D.
Anesthesiology
3533 SOUTHERN BLVD, STE 3400
KETTERING, OH 45429
Montgomery County (937) 293-8228
NICHOLAS A DONINGER PH.D
Clinical Neuropsychologist
3533 SOUTHERN BLVD, SUITE 5200
KETTERING, OH 45429
Montgomery County (937) 395-8043
SOUTHWEST CARDIOLOGY INC
Internal Medicine (Cardiovascular Disease)
3533 SOUTHERN BLVD, SUITE 2100
KETTERING, OH 45429
Montgomery County (937) 293-3486
RAGAVAN NARAYANAN M.D.
Surgery (Surgical Critical Care)
3533 SOUTHERN BLVD, SUITE 2100
KETTERING, OH 45429
Montgomery County (937) 395-8556

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 Peter Pavlina's NPI number?

The NPI number for Peter Pavlina is 1881692341. It was assigned to this individual provider in the NPPES registry on July 8, 2005.

Where is Peter Pavlina located?

Peter Pavlina practices at 3533 Southern Blvd Ste 5650, Kettering, OH 45429. The listed phone number is (937) 294-3611.

What is Peter Pavlina's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

Is Peter Pavlina enrolled in Medicare?

Yes. Peter Pavlina is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Peter Pavlina's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Peter Pavlina reassigns Medicare benefits to Kettering Independent Medical Group Inc (Miamisburg, 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 Peter Pavlina's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Peter Pavlina accept?

Health plans from CareSource and Molina Healthcare list Peter Pavlina 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 Peter Pavlina was last updated on January 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.