Individual provider Active NPI

Michael M Servoss, M.D.

  • Anesthesiology Physician
  • Toledo, OH
National Provider Identifier
1124026331
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
35059596 Issued in OH
Practice address
2142 N Cove Blvd
Toledo, OH 43606-3895
Phone
(419) 471-4491
Fax
(419) 479-6905
NPI assigned
Jul 12, 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
Anesthesiology Physician 207L00000X 35059596 OH Primary

Addresses

Primary practice location

2142 N Cove Blvd
Toledo, OH 43606-3895

Mailing address

2914 S Republic Blvd
Toledo, OH 43615-1912
Phone (419) 531-8808

Other identifiers 4

IdentifierTypeStateIssuer
050064685OtherOHRAILROAD MEDICARE
104071539OtherMIMICHIGAN MEDICAID
0819627OtherOHBCMH
0819627MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mservoss13679@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
I20040702000797 OH Practitioner - Anesthesiology 5799689477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Toledo College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

2109 Hughes Dr
Suite 450
Toledo, OH 43606-5102
Phone (419) 291-2003

2130 W Central Ave
Toledo, OH 43606-3834
Phone (419) 291-4590

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-4000

2801 Bay Park Dr
Oregon, OH 43616-4920
Phone (419) 690-7709

2901 N Reynolds Rd
Toledo, OH 43606
Phone (419) 578-7700

5200 Harroun Rd
Sylvania, OH 43560-2168
Phone (419) 824-1444

Hospital & facility affiliations

  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068
  • Bay Park Community Hospital Hospital, Oregon, OH, CCN 360259

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35059596OHMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians CurrentSince Apr 8, 2013 Accepting new patients
Promedica Central Physicians CurrentSince Apr 8, 2013 Accepting new patients
Consultants in Anesthesiology, Inc Anesthesiology Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Anesthesiology Consultants of Toledo, Inc Anesthesiology Past Accepting new patients
Southern Arizona Anesthesia Services, PC Anesthesiology Past Accepting new patients

Locations

501 Van Buren St
Fostoria, OH 44830
Phone (419) 435-7734

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

2865 N Reynolds Rd
Ste 190
Toledo, OH 43615
Phone (419) 578-7500

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

2130 W Central Ave
Toledo, OH 43606
Phone (419) 291-4590

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

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

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

Organizations & group practices 6

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1124026331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2914 S REPUBLIC BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436151912",
            "telephone_number": "419-531-8808",
            "fax_number": "419-531-9342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2142 N COVE BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063895",
            "telephone_number": "419-471-4491",
            "fax_number": "419-479-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERVOSS",
        "first_name": "MICHAEL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35059596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050064685",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN MEDICAID",
            "identifier": "104071539",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCMH",
            "identifier": "0819627",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0819627",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mservoss13679@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.