NPIMap

Individual provider Active NPI

Jesse Michael Ewald, M.D.

  • Hospitalist Physician
  • Newark, OH
National Provider Identifier
1104196591
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
35.124055 Issued in OH
Practice address
1320 W. Main St
Newark, OH 43055
Phone
(220) 564-1791
Fax
(220) 564-1790
NPI assigned
Jan 3, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.124055 OH
Hospitalist Physician 208M00000X 35.124055 OH Primary

Addresses

Primary practice location

1320 W. Main St
Newark, OH 43055

Mailing address

1320 W. Main St
Newark, OH 43055
Phone (220) 564-1791

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jewald14335@lickingmemorial.medicity.net Other LICKING MEMORIAL PROFESSIONAL CORPORATION

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
I20140730001757 OH Practitioner - HospitalistPractitioner - Internal Medicine 2062638877 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Wright State University Boonshoft School of Medicine, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Licking Memorial Health ProfessionalsGroup PAC ID 6204740731, 235 clinicians
NW Ohio Hospital Medicine Physicians LLCGroup PAC ID 5092169375, 55 clinicians

Practice addresses (Care Compare)

1320 W Main St
Newark, OH 43055-1822
Phone (220) 564-4137

950 W Wooster St
Bowling Green, OH 43402-2603
Phone (844) 270-6621

Hospital & facility affiliations

  • Licking Memorial Hospital Hospital, Newark, OH, CCN 360218
  • Blanchard Valley Hospital Hospital, Findlay, OH, CCN 360095
  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006

Merit-based Incentive Payment System (MIPS)

Final score
85.98 of 100Reported as group
Quality
75.66
Promoting interoperability
100
Improvement activities
40
Cost
75.38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Licking Memorial Professional Corporation CurrentSince Nov 9, 2024 Accepting new patients
NW Ohio Hospital Medicine Physicians LLC CurrentSince Mar 2, 2025 Accepting new patients
Licking Memorial Professional Corp. Past Accepting new patients
Licking Memorial Hospital Past Accepting new patients

Locations

950 W Wooster St
Bowling Green, OH 43402
Phone (419) 354-8900

1900 S Main St
Ste 200
Findlay, OH 45840

120 McMillen Dr
Newark, OH 43055
Phone (220) 564-4806

1320 W Main St
Newark, OH 43055
Phone (740) 348-4151

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1325548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1104196591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 W. MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "43055",
            "telephone_number": "220-564-1791",
            "fax_number": "220-564-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 W. MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "43055",
            "telephone_number": "220-564-1791",
            "fax_number": "220-564-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWALD",
        "first_name": "JESSE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-03",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.124055",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35.124055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jewald14335@lickingmemorial.medicity.net",
            "affiliation": "Y",
            "endpointDescription": "DIRECT EMAIL ADDRESS",
            "affiliationName": "LICKING MEMORIAL PROFESSIONAL CORPORATION",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "OTHER",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "1320 W Main St",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430551822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.