NPIMap

Individual provider Active NPI

Ali S Almudallal, M.D.

  • Neurology Physician
  • Lima, OH
National Provider Identifier
1053407775
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
35076642 Issued in OH
Practice address
770 W High St
Suite 160
Lima, OH 45801-3990
Phone
(419) 996-5224
Fax
(419) 996-5276
NPI assigned
Oct 4, 2006
Last updated
Jan 4, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 35076642 OH Primary
Clinical Neurophysiology Physician 2084N0600X 35076642 OH

Addresses

Primary practice location

770 W High St
Suite 160
Lima, OH 45801-3990

Mailing address

PO Box 636930
Cincinnati, OH 45263-6930

Other identifiers 1

IdentifierTypeStateIssuer
2249696MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050809000581 OH Practitioner - Neurology 9931138013 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Lima Specialty Care LLCGroup PAC ID 7012332364, 254 clinicians

Practice addresses (Care Compare)

770 W High St
Suite 160
Lima, OH 45801-5900
Phone (419) 996-5224

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35076642OHMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians Lima Specialty Care LLC CurrentSince Sep 1, 2020 Accepting new patients
JTDM Family Practice LLC Neurology Past Accepting new patients

Locations

730 W Market St
Lima, OH 45801
Phone (419) 226-4310

770 W High St
Ste 160
Lima, OH 45801
Phone (419) 996-5224

770 W High St
Ste 450
Lima, OH 45801
Phone (419) 996-5069

830 W High St
Ste 201
Lima, OH 45801
Phone (419) 222-3887

830 W High St
Ste 390
Lima, OH 45801
Phone (419) 995-4960

967 Bellefontaine Ave
Lima, OH 45804
Phone (419) 224-1330

12623 Eckel Junction Rd
Ste 2600
Perrysburg, OH 43551
Phone (567) 368-1490

200 Saint Clair Ave
Saint Marys, OH 45885
Phone (419) 394-3387

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

3900 Sunforest Ct
Ste 240
Toledo, OH 43623
Phone (419) 472-3126

Interoperability endpoints

  • Direct secure messaging: aalmudallal53699@direct.bsmhealth.org

Organizations & group practices 5

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

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1053407775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636930",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 W HIGH ST",
            "address_2": "SUITE 160",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458013990",
            "telephone_number": "419-996-5224",
            "fax_number": "419-996-5276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALMUDALLAL",
        "first_name": "ALI",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OH",
            "license": "35076642",
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "OH",
            "license": "35076642",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2249696",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.