NPIMap

Individual provider Active NPI

Andrew J. Croak, D.O.

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Maumee, OH
National Provider Identifier
1073581724
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
OH6943C Issued in OH
Practice address
6005 Monclova Rd Ste 320
Maumee, OH 43537-1862
Phone
(419) 893-7134
Fax
(419) 893-6942
NPI assigned
Mar 9, 2006
Last updated
May 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 34006843 OH
Urology Physician 208800000X 34006843 OH
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X OH6943C OH Primary

Addresses

Primary practice location

6005 Monclova Rd Ste 320
Maumee, OH 43537-1862

Mailing address

6005 Monclova Rd Ste 320
Maumee, OH 43537-1862

Other identifiers 1

IdentifierTypeStateIssuer
2117793MedicaidOH

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
I20040719000126 OH Practitioner - Obstetrics/GynecologyPractitioner - UrologyPractitioner - Other (Physician) 5597744094 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/GynecologyAlso: Urology
Education
Midwestern University, Chicago College of Osteopathic Med, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2213 Cherry St
Toledo, OH 43608-2603

3900 Sunforest CT
Suite 240
Toledo, OH 43623-4481
Phone (419) 475-1600

5075 Monclova Rd
Maumee, OH 43537-1862

5705 Monclova Rd
Maumee, OH 43537-1877
Phone (419) 794-2180

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of the uterus14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OH6943COHMDFemale Pelvic Medicine and Reconstructive Surgery (Obstetrics & Gynecology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians North Specialty Care LLC CurrentSince May 12, 2024 Accepting new patients
Mercy Health Physicians North Specialty Care LLC Gynecology CurrentSince May 12, 2024 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: acroak101078@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 6

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1073581724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6005 MONCLOVA RD STE 320",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6005 MONCLOVA RD STE 320",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371862",
            "telephone_number": "419-893-7134",
            "fax_number": "419-893-6942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROAK",
        "first_name": "ANDREW",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "OH",
            "license": "34006843",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "34006843",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "OH",
            "license": "OH6943C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2117793",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

Verify at the official NPI Registry.