Individual provider Active NPI

Gregor K Emmert Jr., MD

  • Urology Physician
  • Toledo, OH
National Provider Identifier
1093710162
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
3566454 Issued in OH
Practice address
3500 Executive Pkwy
Toledo, OH 43606-1319
Phone
(419) 531-8558
Fax
(419) 578-5939
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 3566454 OH Primary

Addresses

Primary practice location

3500 Executive Pkwy
Toledo, OH 43606-1319

Mailing address

3500 Executive Pkwy
Toledo, OH 43606-1319
Phone (419) 531-8558

Other identifiers 2

IdentifierTypeStateIssuer
340008355OtherOHRAILROAD MEDICARE
0977948MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gemmert13596@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040325000074 OH Practitioner - Urology 2264324482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Ohio State University College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Genito-Urinary Surgeons LLCGroup PAC ID 3971757238, 19 clinicians

Practice addresses (Care Compare)

5757 Monclova Rd
Suite 6
Maumee, OH 43537-1863
Phone (419) 897-7751

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3566454OHMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Genito-Urinary Surgeons LLC Urology CurrentSince Jan 1, 2013 Accepting new patients
Genito Urinary Surgeons, Inc. Urology Current Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

5757 Monclova Rd
Ste 6
Maumee, OH 43537
Phone (419) 491-6333

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

2120 W Central Ave
Toledo, OH 43606
Phone (419) 531-8558

3500 Executive Pkwy
Toledo, OH 43606
Phone (419) 531-7860

Interoperability endpoints

  • Direct secure messaging: gemmert13596@direct.promedica.org

Organizations & group practices 3

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.

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1093710162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 EXECUTIVE PKWY",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436061319",
            "telephone_number": "419-531-8558",
            "fax_number": "419-578-5939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 EXECUTIVE PKWY",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436061319",
            "telephone_number": "419-531-8558",
            "fax_number": "419-578-5939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMMERT",
        "first_name": "GREGOR",
        "middle_name": "K",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "3566454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "340008355",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0977948",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gemmert13596@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.