Eric David Vanfossen, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0805 Issued in OH

Practice address

1205 Fairington Dr
Sidney, OH 45365-8144

Phone

(937) 492-8431

NPI assigned

Feb 7, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wilson Care, LLCGroup PAC ID 4385549666, 58 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wilson Memorial Hospital Hospital, Sidney, OH, CCN 360013
• Upper Valley Medical Center Hospital, Troy, OH, CCN 360174

Merit-based Incentive Payment System (MIPS)

Final score

62.04 of 100Reported as group

Quality

29.8

Improvement activities

40

Cost

76.6

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/107/brand/1/csg/1/fhir/r4
• Direct secure messaging: evanfossen1539094@direct.osumc.edu

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

• Wilson Care, LLC

  • Family Medicine Physician
  • Sidney, OH
  • NPI 1205886926
  Medicare reassignment Care Compare group NPD
• Pure Healthcare LLC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Dayton, OH
  • NPI 1619115045
  Medicare reassignment
• The Hospice of Dayton, Inc.

  • Community Based Hospice Care Agency
  • Dayton, OH
  • NPI 1346220142
  Medicare reassignment
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Primecare Physicians of West Central Ohio, Inc

  • General Practice Physician
  • Sidney, OH
  • NPI 1609084375
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Shelby County Memorial Hospital Association Inc.

  • General Acute Care Hospital
  • Sidney, OH
  • NPI 1639174204
  Care Compare affiliation
• Upper Valley Medical Center

  • General Acute Care Hospital
  • Troy, OH
  • NPI 1184638942
  Care Compare affiliation

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1083754287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21039 GEYER DR",
            "city": "WAPAKONETA",
            "state": "OH",
            "postal_code": "458958815",
            "telephone_number": "937-596-5386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 FAIRINGTON DR",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453658144",
            "telephone_number": "937-492-8431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANFOSSEN",
        "first_name": "ERIC",
        "middle_name": "DAVID",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "0805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fossen@wilsonhospital.medicity.net",
            "affiliation": "N",
            "endpointDescription": "Sidney, Oh. 45365, US",
            "address_1": "1205 Fairington Dr",
            "city": "Sidney",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453658144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fossen@wilsonhospital.medicity.net",
            "affiliation": "N",
            "address_1": "1205 Fairington Dr",
            "city": "Sidney",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453658144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Philip W Valentine, OD
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• Valley Eye Institute Inc
• Georgia Van Horn
• Alexis Danielle Vanhook, IP
• Jeffery R Vantreese
• Victress Health and Wellness LLC
• Michael J Vietti, MD
• Voca Corp

• Medical Physician Assistant in Sidney, OH
• Providers in Sidney, OH by specialty
• Medical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.