NPIMap

Individual provider Active NPI

Mark T Mueller, M.D.

  • Family Medicine Physician
  • Lima, OH
National Provider Identifier
1063464923
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35076924 Issued in OH
Practice address
2745 Fort Amanda Rd
Lima, OH 45805-4805
Phone
(419) 996-5700
Fax
(419) 996-5639
NPI assigned
May 17, 2006
Last updated
Apr 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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 35076924 OH Primary

Addresses

Primary practice location

2745 Fort Amanda Rd
Lima, OH 45805-4805

Mailing address

PO Box 636930
Cincinnati, OH 45263-0001

Other identifiers 2

IdentifierTypeStateIssuer
4047473OtherOHMEDICARE NUMBER
2237369MedicaidOH

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
I20040809000024 OH Practitioner - Family Practice 2062498710 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Ohio, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Lima, LLCGroup PAC ID 3375607351, 54 clinicians

Practice addresses (Care Compare)

2745 Fort Amanda Rd
Lima, OH 45805-4805
Phone (419) 996-5700

2751 Fort Amanda Rd
Lima, OH 45805-4805
Phone (419) 996-5700

770 W High St
Suite 450
Lima, OH 45801-3962
Phone (419) 996-5633

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Lima, LLC Family Medicine CurrentSince Jan 1, 2011 Accepting new patients
Mercy Health Physicians Lima Specialty Care LLC CurrentSince May 5, 2021 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Mercy Health-St Ritas Medical Center LLC Past Accepting new patients

Locations

2195 Allentown Rd
Lima, OH 45805
Phone (419) 227-2245

2745 Fort Amanda Rd
Lima, OH 45805
Phone (419) 996-5700

582 N Cable Rd
Lima, OH 45805
Phone (419) 996-2500

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

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

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

Interoperability endpoints

  • Direct secure messaging: mmueller39541@direct.bsmhealth.org

Organizations & group practices 4

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 7

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1063464923",
    "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": "452630001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2745 FORT AMANDA RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458054805",
            "telephone_number": "419-996-5700",
            "fax_number": "419-996-5639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUELLER",
        "first_name": "MARK",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35076924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "4047473",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2237369",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.