NPIMap

Organization Active NPI

Ultimate Care Emergency Physicians LLC

  • Emergency Medicine Physician
  • Bowling Green, OH
National Provider Identifier
1083202816
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
ULTIMATE CARE EMERGENCY PHYSICIANS LLC
Practice address
950 W Wooster St
Bowling Green, OH 43402-2603
Phone
(419) 354-8900
NPI assigned
Jan 7, 2021
Last updated
Jul 14, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Authorized official

Name
Yazan Musallem Sarsour, DONPI 1629021324
Title
Medical Director/ Chief
Phone
(781) 280-1683

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

950 W Wooster St
Bowling Green, OH 43402-2603

Mailing address

8 Oak Park Dr
Bedford, MA 01730-1414
Phone (781) 280-1683

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210212001392 OH Part B Supplier - Clinic/Group Practice 2668887209 Receives reassigned benefits from 27 practitioners
Practice locations: Bowling Green, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 28

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626220800000",
    "number": "1083202816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 OAK PARK DR",
            "city": "BEDFORD",
            "state": "MA",
            "postal_code": "017301414",
            "telephone_number": "781-280-1683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 W WOOSTER ST",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434022603",
            "telephone_number": "419-354-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTIMATE CARE EMERGENCY PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-07",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A",
        "authorized_official_last_name": "SARSOUR",
        "authorized_official_first_name": "YAZAN",
        "authorized_official_middle_name": "MUSALLEM",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/ CHIEF",
        "authorized_official_telephone_number": "781-280-1683",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.