NPIMap

Organization Active NPI

Usacs Critical Care Medicine Services of Ohio, LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Springfield, OH
National Provider Identifier
1104560580
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
Legal business name
USACS CRITICAL CARE MEDICINE SERVICES OF OHIO, LLC
Practice address
100 Medical Center Dr
Springfield, OH 45504-2687
Phone
(844) 474-4019
Fax
(330) 493-8677
NPI assigned
Apr 22, 2022
Last updated
Feb 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Authorized official

Name
Dominic Joseph Bagnoli Jr.NPI 1659439453
Title
Chairman
Phone
(330) 493-4443

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0200X Primary

Addresses

Primary practice location

100 Medical Center Dr
Springfield, OH 45504-2687

Mailing address

4535 Dressler Rd NW
Canton, OH 44718-2545
Phone (844) 474-4019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220819000220 OH Part B Supplier - Clinic/Group Practice 5991188286 Receives reassigned benefits from 56 practitioners
Practice locations: Springfield, OH
O20240326001604 TX Part B Supplier - Clinic/Group Practice 5991188286 Receives reassigned benefits from 2 practitioners
Practice locations: Austin, TX; San Antonio, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 58

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.

View all 58

NPI Registry JSON

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

{
    "created_epoch": "1650585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739318400000",
    "number": "1104560580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182545",
            "telephone_number": "844-474-4019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER DR",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455042687",
            "telephone_number": "844-474-4019",
            "fax_number": "330-493-8677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USACS CRITICAL CARE MEDICINE SERVICES OF OHIO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-22",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A",
        "authorized_official_last_name": "BAGNOLI",
        "authorized_official_first_name": "DOMINIC",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "330-493-4443",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; 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.