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DR. AHMAD REZA SEDAGHAT M.D., PH.D.
NPI 1902049687
Otolaryngology in Cincinnati, OH

Active since April 10, 2009PECOS EnrolledAccepts Medicare Assignment
78.78/100
CMS Quality Rating
222 PIEDMONT AVE, CINCINNATI, OH 45219(513) 475-8400(513) 475-8228 Get Directions Write a Review

NPPES record last updated: February 19, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 19, 2019, May 1, 2018 (2 updates tracked since 2018).

About Dr. Ahmad Reza Sedaghat M.d., Ph.d. NPPES

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

DR. AHMAD REZA SEDAGHAT M.D., PH.D. (NPI 1902049687) is an individual otolaryngology provider in Cincinnati, Ohio, licensed in Ohio (35135644) and active in the NPI registry since April 2009. He is enrolled in Medicare PECOS, is affiliated with University Of Cincinnati Medical Center, Llc, and is a graduate of Johns Hopkins University School Of Medicine (2009).

NPPES Registry Identity

NPI1902049687
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameDR. AHMAD REZA SEDAGHATCredential: M.D., PH.D.
Location Address222 PIEDMONT AVECincinnati, OH 45219-4231
Mailing Address2830 Victory Parkway, Payor EnrollmentCincinnati, OH 45206-1785 · (513) 585-5507 · Fax (513) 585-5511
Phone(513) 475-8400
Fax(513) 475-8228
Sole ProprietorNo
Medical School CMSJohns Hopkins University School Of MedicineGraduated 2009
Enumeration DateApril 10, 2009
Last NPPES UpdateFebruary 19, 20192 updates tracked since enumeration
✔ NPI 1902049687 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License✔ Licensed in OH · 35135644
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
222 PIEDMONT AVE, Cincinnati, OH 45219
Open in Google Maps ↗

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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Ahmad Reza Sedaghat M.d., Ph.d. 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 ID42470056
PECOS Enrollment IDI20190318002225
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.

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.

Diagnostic exam of nasal passages using an endoscope 31231
A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.
356 services224 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.
340 services187 patients
Professional service for multiple injections of allergen 95117
The professional service for multiple injections of allergens involves administering small doses of specific allergens into your body. This is done to help your immune system become less sensitive to them, reducing your allergic reaction over time. It's a safe, effective way to manage allergies.
83 services14 patients
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.
68 services68 patients
Biopsy or removal of nasal polyp or tissue using an endoscope 31237
A nasal biopsy or polyp removal is a procedure where an endoscope, a thin tube with a light and camera, is inserted into the nose. This allows the doctor to see and remove abnormal tissues or polyps, which are small growths. This procedure helps diagnose or treat nasal issues.
38 services15 patients

Hospital Affiliations CMS Care Compare 2

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

University Of Cincinnati Medical Center, LLC

Acute Care Hospitals · Cincinnati, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360003
Location3188 Bellevue AvenueCincinnati, OH 45219 · Hamilton County
Emergency services Birthing friendly

West Chester Hospital

Acute Care Hospitals · West Chester, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360354
Location7700 University DriveWest Chester, OH 45069 · Butler County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45219 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
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
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.

78.78/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality70.42
Promoting Interoperability100
Improvement Activities40
Cost58.86

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.

BERNICE K KLABEN PH.D.-CCC-SLP-BRS-S
Speech-Language Pathologist
222 PIEDMONT AVE
CINCINNATI, OH 45219
Hamilton County (513) 475-8400
BARBARA RUTH CUNNINGHAM RN
Allergy & Immunology (Clinical & Laboratory Immunology)
222 PIEDMONT AVE, SUITE 5200
CINCINNATI, OH 45219
Hamilton County (513) 475-8400
MRS. CHERYL DOREEN HERRLE CNP
Nurse Practitioner (Gerontology)
222 PIEDMONT AVE
CINCINNATI, OH 45219
Hamilton County (513) 475-7400
REBECCA HARDT CNP
Nurse Practitioner (Adult Health)
222 PIEDMONT AVE
CINCINNATI, OH 45219
Hamilton County (513) 475-7505
MRS. RONDA BAUER
Licensed Practical Nurse
222 PIEDMONT AVE, SUITE 5200
CINCINNATI, OH 45219
Hamilton County (513) 475-7363
CARRIE LYNN JENNINGS CNP
Nurse Practitioner (Family)
222 PIEDMONT AVE
CINCINNATI, OH 45219
Hamilton County (513) 475-7505
ALBERTO ESPAY MD
Psychiatry & Neurology (Neurology)
222 PIEDMONT AVE, SUITE 3200
CINCINNATI, OH 45219
Hamilton County (513) 475-8730
GREGORY WAYNE ROUAN M.D.
Internal Medicine
222 PIEDMONT AVE, STE 6000
CINCINNATI, OH 45219
Hamilton County (513) 475-7880

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 Ahmad Sedaghat's NPI number?

The NPI number for Ahmad Sedaghat is 1902049687. It was assigned to this individual provider in the NPPES registry on April 10, 2009.

Where is Ahmad Sedaghat located?

Ahmad Sedaghat practices at 222 Piedmont Ave, Cincinnati, OH 45219. The listed phone number is (513) 475-8400.

What is Ahmad Sedaghat's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Ahmad Sedaghat enrolled in Medicare?

Yes. Ahmad Sedaghat 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.

What insurance does Ahmad Sedaghat accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 3 other insurers list Ahmad Sedaghat 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 Ahmad Sedaghat affiliated with any hospitals?

According to CMS data, Ahmad Sedaghat is affiliated with University Of Cincinnati Medical Center, LLC and West Chester Hospital.

When was this NPI record last updated?

The NPPES record for Ahmad Sedaghat was last updated on February 19, 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.