Individual provider Active NPI

Thomas Paul Rak, M.D.

  • Plastic Surgery Physician
  • Springfield, OH
National Provider Identifier
1124019807
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
35-069331R Issued in OH
Practice address
415 E Home Rd
Springfield, OH 45503-2708
Phone
(937) 399-9997
Fax
(937) 399-5633
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 35-069331R OH Primary

Addresses

Primary practice location

415 E Home Rd
Springfield, OH 45503-2708

Mailing address

415 E Home Rd
Springfield, OH 45503-2708
Phone (937) 399-9997

Other identifiers 1

IdentifierTypeStateIssuer
0207029MedicaidOH

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
I20070914000396 OH Practitioner - Plastic and Reconstructive Surgery 4284728718 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Medical College of Ohio, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

415 E Home Rd
Springfield, OH 45503-2708
Phone (937) 399-9997

Hospital & facility affiliations

  • Ohio Valley Surgical Hospital Hospital, Springfield, OH, CCN 360355
  • Springfield Regional Medical Center Hospital, Springfield, OH, CCN 360086

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision107
Removal of skin lesions18
Removal or shaving of skin growth14
Skin biopsy47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-069331ROHMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rak Plastic and Reconstructive Surgery Inc Plastic Surgery CurrentSince Apr 1, 1998 Accepting new patients
Ohio Valley Medical Center, LLC Current Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

218 Northparke Dr
Ste A
Springfield, OH 45503
Phone (513) 399-9997

415 E Home Rd
Springfield, OH 45503
Phone (937) 390-6584

Interoperability endpoints

  • Direct secure messaging: trak@direct.ovsurgical.com

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 3

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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1124019807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 E HOME RD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455032708",
            "telephone_number": "937-399-9997",
            "fax_number": "937-399-5633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 E HOME RD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455032708",
            "telephone_number": "937-399-9997",
            "fax_number": "937-399-5633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAK",
        "first_name": "THOMAS",
        "middle_name": "PAUL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "OH",
            "license": "35-069331R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0207029",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

Verify at the official NPI Registry.