JOHN C BRENEMAN MD
NPI 1922090075
Radiology - Radiation Oncology in Cincinnati, OH
Quality Rating: 78.78 out of 100 score
NPI Status: Active since August 16, 2005
Contact Information
234 GOODMAN ST
CINCINNATI, OH
ZIP 45219
Phone: (513) 584-3494
Fax: (513) 584-4007
- Individual
- Male
- Radiology
- Radiation Oncology
- Accepts Insurance
- PECOS Enrolled
About JOHN BRENEMAN
This page provides the complete NPI Profile along with additional information for John Breneman, a provider established in Cincinnati, Ohio with a medical specialization in Radiology, focusing in radiation oncology . The healthcare provider is registered in the NPI registry with number 1922090075 assigned on August 2005. The practitioner's primary taxonomy code is 2085R0001X with license number 35-05-1974 (OH). The provider is registered as an individual and his NPI record was last updated 8 years ago.
- NPI
- 1922090075
- Provider Name
- JOHN C BRENEMAN MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 234 GOODMAN ST CINCINNATI, OH 45219
- Location Phone
- (513) 584-3494
- Location Fax
- (513) 584-4007
- Mailing Address
- PO BOX 636256 CENTRAL CREDENTIALING CINCINNATI, OH 45263
- Mailing Phone
- (513) 585-5507
- Mailing Fax
- (513) 584-4007
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-16-2005
- Last Update Date
- 02-08-2018
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Radiology Radiation Oncology
- Taxonomy Code
- 2085R0001X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 35-05-1974
- License State
- OH
- Taxonomy Description
- A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Essential 10150 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Essential 10150 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Essential 6500 HSA (+ Incentives) - HMO
- Anthem Bronze Essential 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Essential POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Essential POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Pathway 10600 ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway 10600 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway 8500 for HSA - HMO
- Bronze 7500 $25 Generic Drugs - HMO
- Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
- Core Gold 1500 $10 Generic Drugs - HMO
- Core Gold 1500 $10 Generic Drugs + Adult Vision & Fitness - HMO
- Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
- Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
- Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
- Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
- Gold 2000 $15 Generic Drugs - HMO
- Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
- Bronze $8,300 w/ Adult Dental ON-EX - HMO
- Bronze $8,300 w/ Virtual & Wellness ON-EX - HMO
- Bronze HSA $7,300 ON-EX - HMO
- Bronze Standard w/ Virtual & Wellness - HMO
- Gold $1,000 w/ Adult Dental ON-EX - HMO
- Gold $1,000 w/ Virtual & Wellness ON-EX - HMO
- Gold $500 w/ Virtual & Wellness ON-EX - HMO
- Gold Standard w/ Virtual & Wellness - HMO
- Silver $5,000 w/ Adult Dental ON-EX - HMO
- Silver $5,000 w/ Virtual & Wellness ON-EX - HMO
- Molina Bronze Enhanced 3500 - HMO
- Molina Bronze Enhanced 3500 Plus with Adult Dental and Vision - HMO
- Molina Bronze Enhanced 3500 Plus with Adult Vision - HMO
- Molina Bronze Saver 7000 - HMO
- Molina Bronze Saver 7000 Plus with Adult Dental and Vision - HMO
- Molina Bronze Saver 7000 Plus with Adult Vision - HMO
- Molina Bronze Smart Heart Health - HMO
- Molina Bronze Standard - HMO
- Molina Gold Core 1640 - HMO
- Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
- Bronze Classic 4700 - HMO
- Bronze Classic Standard - HMO
- Bronze Elite + PCP Saver Plus - HMO
- Bronze Simple Breathe Easy with Enhanced COPD Benefits - HMO
- Bronze Simple Chronic Care CKM - HMO
- Bronze Simple Diabetes - HMO
- Gold Classic - HMO
- Gold Classic Standard - HMO
- Gold Elite Saver Plus - HMO
- Silver Classic Standard - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 0120692000 | MEDICAID (05) | WV | |
| 200039460A | MEDICAID (05) | IN | |
| 64785504 | MEDICAID (05) | KY | |
| 0655279 | OTHER (01) | OH | AETNA |
| 0000F5185 | MEDICAID (05) | NM | |
| 0591506 | MEDICAID (05) | OH | |
| 16-20999 | OTHER (01) | OH | UNITED HEALTHCARE |
| P8B037061 | MEDICAID (05) | TX | |
| 295801 | OTHER (01) | OH | BLACK LUNG |
| 920000710 | OTHER (01) | OH | RAILROAD MEDICARE |
Medicare Participation & PECOS Enrollment Status
John Breneman is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Calculation of radiation therapy dose
Ct guidance for insertion of radiation therapy fields
Design and construction of radiation treatment device for high precision radiation therapy
Established patient office or other outpatient visit, 20-29 minutes
High precision radiation therapy planning
Radiation treatment management, 5 treatment sessions
Stereoscopic x-ray guidance for localization of target volume for the delivery of radiation therapy
Radiation therapy dose calculation is a process to determine the exact amount of radiation needed to treat a specific area in the body. This calculation helps ensure the treatment is effective while minimizing harm to healthy tissues. It's a key part of planning your radiation therapy.
This service was performed 47 times for 14 patientsCT guidance for insertion of radiation therapy fields involves using a CT scan to accurately map the area of your body where radiation will be applied. This ensures the radiation targets only the necessary area, minimizing impact to healthy tissues.
This service was performed 137 times for 38 patientsA radiation treatment device is custom-made for each patient to target cancer cells with high precision. It's designed to focus radiation on the tumor, sparing healthy tissue. This process ensures effective therapy while minimizing side effects.
This service was performed 15 times for 14 patientsThis 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.
This service was performed 29 times for 29 patientsHigh precision radiation therapy planning involves detailed mapping of your body to target cancer cells accurately. Advanced imaging techniques help identify the exact location of the tumor, minimizing harm to healthy tissues. This personalized approach enhances effectiveness and reduces side effects.
This service was performed 15 times for 14 patientsRadiation treatment management involves a series of 5 sessions where targeted radiation is used to destroy or shrink cancer cells in your body. Each session is carefully planned to maximize effectiveness while minimizing harm to healthy tissues. You may experience side effects which will be closely monitored and managed for your comfort.
This service was performed 20 times for 11 patientsStereoscopic x-ray guidance is a technique used in radiation therapy. It involves taking multiple X-ray images from different angles to create a 3D picture of the area to be treated. This helps accurately pinpoint the exact location for radiation delivery, ensuring the therapy is as effective as possible.
This service was performed 99 times for 24 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 45219 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99205
- Average New Patient Price $166.65
- Minimum New Patient Price $54.34
- Maximum New Patient Price $166.65
- Average New Patient Copayment $41.66
- Minimum New Patient Copayment $13.58
- Maximum New Patient Copayment $41.66
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $68.07
- Minimum Established Patient Price $17.1
- Maximum Established Patient Price $135.4
- Average Established Patient Copayment $17.01
- Minimum Established Patient Copayment $4.27
- Maximum Established Patient Copayment $33.85
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Overall MIPS Quality Performance
The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 78.78, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
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Final Score: 78.78 out of 100
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
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Quality Score: 70.42
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
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Promoting Interoperability Score: 100
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data. -
Improvement Activities Score: 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores. -
Cost Score: 58.86
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores. -
Cost Score: 58.86
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1922090075, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 55 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
CINCINNATI, OH 45219
CINCINNATI, OH 45219
CINCINNATI, OH 45219
CINCINNATI, OH 45219
CINCINNATI, OH 45219
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1922090075, enumerated as an "individual" on August 16, 2005.
The provider is located at 234 GOODMAN ST CINCINNATI, OH 45219 and the phone number is (513) 584-3494.
Radiology with taxonomy code 2085R0001X and a focus in Radiation Oncology.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, CareSource,. Please consult your insurance carrier or call the provider to verify.