NPIMap

Individual provider Active NPI

David M Cooley, MD

  • Gastroenterology Physician
  • Bryan, OH
National Provider Identifier
1083972814
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
35.132488 Issued in OH
Practice address
433 W High St
Bryan, OH 43506-1690
Phone
(419) 630-2021
Fax
(419) 630-2022
NPI assigned
Apr 30, 2012
Last updated
Jul 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Gastroenterology Physician 207RG0100X 35.132488 OH Primary

Addresses

Primary practice location

433 W High St
Bryan, OH 43506-1690

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Other identifiers 1

IdentifierTypeStateIssuer
0304652MedicaidOH

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
I20180726001415 OH Practitioner - GastroenterologyPractitioner - Internal Medicine 5597998567 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Ohio State University College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Community Health Associates, Inc.Group PAC ID 0941114250, 100 clinicians

Practice addresses (Care Compare)

121 Westfield Dr
Suite 1
Archbold, OH 43502-1005
Phone (419) 445-2015

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.74 of 100Reported as group
Quality
87.56
Promoting interoperability
100
Improvement activities
40
Cost
71.58

Merit-based Incentive Payment System (MIPS)

Final score
85.81 of 100Reported as group
Quality
80.59
Promoting interoperability
100
Improvement activities
40
Cost
72.11

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy225
Upper gastrointestinal (GI) endoscopy for acid reflux253

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.132488OHMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospitals and Wellness Centers CurrentSince Sep 1, 2018 Accepting new patients
Community Hospitals and Wellness Centers CurrentSince Sep 1, 2018 Accepting new patients
Midwest Community Health Associates, Inc. CurrentSince Jun 20, 2024 Accepting new patients
Midwest Community Health Associates, Inc. CurrentSince Jun 20, 2024 Accepting new patients
Community Hospitals and Wellness Centers Past Accepting new patients

Locations

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

121 Westfield Dr
Archbold, OH 43502
Phone (419) 445-2015

121 Westfield Dr
Ste 1
Archbold, OH 43502
Phone (419) 445-2015

433 W High St
Bryan, OH 43506
Phone (419) 636-1131

442 W High St
Bryan, OH 43506
Phone (260) 266-8210

Interoperability endpoints

  • Direct secure messaging: dcooley130767@direct.parkviewexchange.com

Organizations & group practices 5

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 5

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": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1083972814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 W HIGH ST",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "435061690",
            "telephone_number": "419-630-2021",
            "fax_number": "419-630-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOLEY",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-30",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "35.132488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0304652",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, OH

Sources for this page

Verify at the official NPI Registry.