Madeline Agosto, M.D.
Individual provider Active NPI Family Medicine Physician · Lima, OH
NPI 1053363580 · NPPES record last updated Mar 17, 2008
Key facts
- NPI
- 1053363580
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 35 06 8718 (OH)
- Practice address
- 915 W Market St
Lima, OH 45805-2768 - Phone
- (419) 229-4747
- Fax
- (419) 224-3348
- NPI assigned
- May 16, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- West Market Street Family Phys
Practice addresses (Care Compare)
915 W Market St
Suite E
Lima, OH 45805-2769
Phone (419) 229-4747
915 W Market St E
Lima, OH 45805-2769
Hospital & facility affiliations
- Mercy Health St Ritas Medical Center
- Lima Memorial Health System
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120220000410 | OH | Practitioner - Family Practice | 8921085705 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35 06 8718 | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Market Street Family Phys | Family Medicine | Current |
Accepting new patients |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Locations
915 W Market St
Ste E
Lima, OH 45805
Phone (419) 229-4747
915 W Market St
Lima, OH 45805
Phone (419) 228-3600
Interoperability endpoints
- magosto52453@direct.bsmhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35 06 8718 | OH | Yes |
Addresses
Primary practice location
915 W Market St
Lima, OH 45805-2768
Mailing address
589 Wildbrook LN
Lima, OH 45807-1991
Phone (419) 999-1060
Other providers in Lima, OH
- Vivek Agarwal
- Manu B Aggarwal
- Seth O. Agiro
- Pauletta Marie Agler
- Dale R Agnew
- Aurelia Aguilar
- Thomas Lee Ahman
- Syed Ahmed
- Mohammed Junaid Akbani
- Matthew M Akers
All providers in Lima, OH · Family Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.