Organization Active NPI

Russell a Maringer OD Inc.

  • Optometrist
  • Tiffin, OH
National Provider Identifier
1083804074
Registry record updated Feb 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5494 Issued in OH
Legal business name
RUSSELL A MARINGER OD INC.
Practice address
455 E Market St
Suite F
Tiffin, OH 44883-1707
Phone
(419) 447-5616
Fax
(866) 462-0224
NPI assigned
Jul 26, 2007
Last updated
Feb 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2008

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

Authorized official

Name
Dr. Russell A Maringer, OD, MSNPI 1306926068
Title
Optometrist
Phone
(419) 447-5616

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 5494 OH Primary

Addresses

Primary practice location

455 E Market St
Suite F
Tiffin, OH 44883-1707

Mailing address

455 E Market St
Ste F
Tiffin, OH 44883-1769
Phone (419) 447-5616

Other identifiers 1

IdentifierTypeStateIssuer
2499998MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040907001382 OH Part B Supplier - Clinic/Group Practice 9830165224 Receives reassigned benefits from 2 practitioners
Practice locations: Marblehead, OH; Oak Harbor, OH

National Provider Directory

National Provider Directory

Locations

142 W Water St
Ste L
Oak Harbor, OH 43449
Phone (419) 898-1918

34 W Market St
Tiffin, OH 44883
Phone (419) 447-5616

455 E Market St
Ste F
Tiffin, OH 44883
Phone (419) 443-0525

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203033600000",
    "number": "1083804074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 E MARKET ST",
            "address_2": "STE F",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "448831769",
            "telephone_number": "419-447-5616",
            "fax_number": "866-462-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 E MARKET ST",
            "address_2": "SUITE F",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "448831707",
            "telephone_number": "419-447-5616",
            "fax_number": "866-462-0224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL A MARINGER OD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2008-02-15",
        "status": "A",
        "authorized_official_last_name": "MARINGER",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "419-447-5616",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD, MS"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2499998",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tiffin, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; 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.