Individual provider Active NPI

Mark Anthony Naddaf, MD

  • Pediatric Gastroenterology Physician
  • Toledo, OH
National Provider Identifier
1124142500
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
89490 Issued in OH
Practice address
2222 Cherry St
Suite 1600
Toledo, OH 43608-2673
Phone
(419) 251-4880
Fax
(419) 251-7714
NPI assigned
Mar 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301083864 MI
Pediatric Gastroenterology Physician 2080P0206X 4301083864 MI
Pediatric Gastroenterology Physician 2080P0206X 89490 OH Primary

Addresses

Primary practice location

2222 Cherry St
Suite 1600
Toledo, OH 43608-2673

Mailing address

700 Childrens Dr
Columbus, OH 43205-2664
Phone (614) 722-2000

Other practice location 1

2213 Cherry St
Toledo, OH 43608-2603
Phone (567) 290-6543

Other practice location 2

4126 N Holland Sylvania Rd Ste 220
Toledo, OH 43623-3537
Phone (419) 251-4880

Other practice location 3

730 W. High Street
Lima, OH 45801
Phone (419) 251-4880

Other practice location 4

500 W Market St
Tiffin, OH 44883-2610
Phone (419) 251-8035

Other practice location 5

1400 E 2nd St
Defiance, OH 43512-9905
Phone (419) 251-4880

Other practice location 6

605 3rd Ave
Fremont, OH 43420-3269
Phone (419) 251-4880

Other identifiers 1

IdentifierTypeStateIssuer
2743697MedicaidOH

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
I20110126000678 OH Practitioner - Pediatric Medicine 8022179019 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Pediatric Specialists LLCGroup PAC ID 6709279276, 21 clinicians

Practice addresses (Care Compare)

2222 Cherry St
Toledo, OH 43608-2673
Phone (419) 251-4300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301083864MIMDPediatrics Physician
89490OHMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians - North, LLC CurrentSince Oct 29, 2010 Accepting new patients
Mercy Medical Partners Northern Region Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians-North LLC Pediatrics CurrentSince Oct 29, 2010 Accepting new patients
Mercy Medical Partners Northern Region LLC CurrentSince Jan 1, 2012 Accepting new patients
Promedica Children'S Specialists Pediatrics CurrentSince Oct 1, 2023 Accepting new patients
Northwest Pediatric Specialists, LLC Pediatrics CurrentSince Mar 1, 2022 Accepting new patients
Mercy Medical Partners Northern Region Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Medical Partners Northern Region LLC CurrentSince Jan 1, 2012 Accepting new patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

1400 E 2nd St
Defiance, OH 43512
Phone (419) 784-1414

605 3rd Ave
Fremont, OH 43420
Phone (419) 355-8070

3521 Briarfield Blvd
Maumee, OH 43537
Phone (419) 794-7259

1600 E Riverview Ave
Ste 101
Napoleon, OH 43545
Phone (419) 592-8774

500 W Market St
Tiffin, OH 44883
Phone (419) 251-8210

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

4126 N Holland Sylvania Rd
Ste 220
Toledo, OH 43623
Phone (419) 517-7600

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

2213 Cherry St
Toledo, OH 43608
Phone (419) 251-4283

3900 Sunforest Ct
Ste 240
Toledo, OH 43623
Phone (419) 472-3126

2222 Cherry St
Toledo, OH 43608
Phone (419) 251-4200

2121 Hughes Dr
Ste 220
Toledo, OH 43606
Phone (419) 291-7403

2200 Jefferson Ave
Fl 4
Toledo, OH 43604
Phone (419) 251-1400

2222 Cherry St
Ste 1600
Toledo, OH 43608
Phone (419) 251-6600

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2229/brand/3/csg/621/fhir/r4
  • FHIR API: https://hkc.nationwidechildrens.org/FHIR/MYCHART/api/FHIR/R4
  • Direct secure messaging: mnaddaf27140@direct.bsmhealth.org

Organizations & group practices 11

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": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1124142500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 CHERRY ST",
            "address_2": "SUITE 1600",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082673",
            "telephone_number": "419-251-4880",
            "fax_number": "419-251-7714"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2213 Cherry St",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436082603",
            "country_code": "US",
            "telephone_number": "567-290-6543",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4126 N Holland Sylvania Rd Ste 220",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436233537",
            "country_code": "US",
            "telephone_number": "419-251-4880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "730 W. High Street",
            "address_purpose": "LOCATION",
            "city": "Lima",
            "state": "OH",
            "postal_code": "45801",
            "country_code": "US",
            "telephone_number": "419-251-4880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 W Market St",
            "address_purpose": "LOCATION",
            "city": "Tiffin",
            "state": "OH",
            "postal_code": "448832610",
            "country_code": "US",
            "telephone_number": "419-251-8035",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 E 2nd St",
            "address_purpose": "LOCATION",
            "city": "Defiance",
            "state": "OH",
            "postal_code": "435129905",
            "country_code": "US",
            "telephone_number": "419-251-4880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "605 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "OH",
            "postal_code": "434203269",
            "country_code": "US",
            "telephone_number": "419-251-4880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NADDAF",
        "first_name": "MARK",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301083864",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "MI",
            "license": "4301083864",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "OH",
            "license": "89490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2743697",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.