Individual provider Active NPI

Phillip H Fisher, MD

  • Family Medicine Physician
  • Sylvania, OH
National Provider Identifier
1043298250
Registry record updated Dec 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35. 042176 Issued in OH
Practice address
7640 W. Sylvania
Suite K
Sylvania, OH 43560
Phone
(419) 517-1001
Fax
(419) 517-1021
NPI assigned
Jan 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35. 042176 OH Primary

Addresses

Primary practice location

7640 W. Sylvania
Suite K
Sylvania, OH 43560

Mailing address

7640 W. Sylvania
Suite K
Sylvania, OH 43560
Phone (419) 517-1001

Other identifiers 2

IdentifierTypeStateIssuer
0418033MedicaidOH
P00147852OtherOHMEDICARE RAILROAD

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
I20040804001921 OH Practitioner - Family Practice 0840261806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Toledo College of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sylvan Lakes Family Physicians LTDGroup PAC ID 7416928460, 4 clinicians

Practice addresses (Care Compare)

7640 Sylvania Ave
Suite K
Sylvania, OH 43560-9263
Phone (419) 517-1001

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35. 042176OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sylvan Lakes Family Physicians LTD Family Medicine CurrentSince Apr 30, 2003 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

7640 Sylvania Ave
Ste K
Sylvania, OH 43560
Phone (419) 517-1001

Interoperability endpoints

  • Direct secure messaging: pfisher80748@direct.bsmhealth.org

Organizations & group practices 2

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 4

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": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197504000000",
    "number": "1043298250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7640 W. SYLVANIA",
            "address_2": "SUITE K",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "43560",
            "telephone_number": "419-517-1001",
            "fax_number": "419-517-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7640 W. SYLVANIA",
            "address_2": "SUITE K",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "43560",
            "telephone_number": "419-517-1001",
            "fax_number": "419-517-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "PHILLIP",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2007-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35. 042176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0418033",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00147852",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.