Individual provider Active NPI

Mark Sniadanko, DO

  • Emergency Medicine Physician
  • Oregon, OH
National Provider Identifier
1003011834
Registry record updated Oct 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34-008693 Issued in OH
Practice address
2600 Navarre Ave
Oregon, OH 43616-3207
Phone
(419) 696-7500
NPI assigned
Jun 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 34-008693 OH Primary

Addresses

Primary practice location

2600 Navarre Ave
Oregon, OH 43616-3207

Mailing address

4750 Hempstead Station Dr
Kettering, OH 45429-5164
Phone (800) 875-0136

Other identifiers 3

IdentifierTypeStateIssuer
2782743MedicaidOH
000000522688OtherOHBCBS ST CHARLES
P00435623OtherOHRRN MCR ST CHARLES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071119000694 OH Practitioner - Emergency Medicine 1355439779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Professional Services, Inc.Group PAC ID 7214832435, 121 clinicians

Practice addresses (Care Compare)

885 N Sandusky Ave
Upper Sandusky, OH 43351-1031
Phone (419) 294-4991

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34-008693OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professional Services, Inc. Emergency Medicine CurrentSince Jun 1, 2023 Accepting new patients

Locations

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

885 N Sandusky Ave
Upper Sandusky, OH 43351
Phone (419) 294-4991

1250 S Washington St
Van Wert, OH 45891
Phone (419) 232-2077

Interoperability endpoints

  • Direct secure messaging: msniadanko809717@direct.bsmhealth.org
  • FHIR API: https://ihismufhir.osumc.edu/fhir-prd/api/FHIR/R4/

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224115200000",
    "number": "1003011834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 HEMPSTEAD STATION DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454295164",
            "telephone_number": "800-875-0136",
            "fax_number": "937-619-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 NAVARRE AVE",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436163207",
            "telephone_number": "419-696-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNIADANKO",
        "first_name": "MARK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-20",
        "last_updated": "2008-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34-008693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2782743",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ST CHARLES",
            "identifier": "000000522688",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRN MCR ST CHARLES",
            "identifier": "P00435623",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon, OH

Sources for this page

Verify at the official NPI Registry.