Individual provider Active NPI

Nayef Mazloum

  • Family Nurse Practitioner
  • Sylvania, OH
National Provider Identifier
1104471796
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0040016 Issued in OH
Practice address
5200 Harroun Rd
Sylvania, OH 43560-2168
Phone
(567) 585-0380
Fax
(567) 585-0381
NPI assigned
Aug 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0040016 OH Primary
Registered Nurse 163W00000X 4704377060 OH

Addresses

Primary practice location

5200 Harroun Rd
Sylvania, OH 43560-2168

Mailing address

5200 Harroun Rd
Sylvania, OH 43560-2168

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20251010000159 OH Practitioner - Nurse Practitioner 3870090228 Reassigns benefits to 1 organization
I20260506003661 MI Practitioner - Nurse Practitioner 3870090228 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Michigan Medical School, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Multi Specialty PhysiciansGroup PAC ID 7113182809, 269 clinicians

Practice addresses (Care Compare)

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-1111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704377060OHMDRegistered Nurse
APRN.CNP.0040016OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Multi Specialty Physicians CurrentSince Sep 1, 2025 Accepting new patients
Oakland Lung & Sleep Specialists PLLC Current Accepting new patients

Locations

5200 Harroun Rd
Sylvania, OH 43560
Phone (419) 824-1305

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

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1565308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1104471796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 HARROUN RD",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 HARROUN RD",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602168",
            "telephone_number": "567-585-0380",
            "fax_number": "567-585-0381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZLOUM",
        "first_name": "NAYEF",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-09",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0040016",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "4704377060",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.