Individual provider Active NPI

Alexander Payvandi, DO

  • Emergency Medicine Physician
  • Toledo, OH
National Provider Identifier
1124516380
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34.015291 Issued in OH
Practice address
2213 Cherry St FL
Toledo, OH 43608
Phone
(419) 251-4724
Fax
(419) 251-2698
NPI assigned
Apr 24, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 34.015291 OH Primary

Addresses

Primary practice location

2213 Cherry St FL
Toledo, OH 43608

Mailing address

2213 Cherry St FL
Toledo, OH 43608-2603
Phone (419) 251-4724

Other practice location 1

300 W 27th St
Lumberton, NC 28358-3075
Phone (910) 671-5000

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
I20220222002624 OH Practitioner - Emergency Medicine 5193119873 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Emergency Care Services IncGroup PAC ID 9436475795, 64 clinicians

Practice addresses (Care Compare)

2600 Navarre Ave
Oregon, OH 43616-3207
Phone (419) 696-7411

Hospital & facility affiliations

  • Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.015291OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Emergency Care Services, Inc. Emergency Medicine CurrentSince Feb 1, 2022 Accepting new patients
Emergency Professional Services, Inc. Emergency Medicine CurrentSince Aug 1, 2025 Accepting new patients

Locations

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

2600 Navarre Ave
Oregon, OH 43616
Phone (419) 696-7200

3404 W Sylvania Ave
Toledo, OH 43623
Phone (419) 407-1422

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

Organizations & group practices 2

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 1

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": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1124516380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 CHERRY ST FL",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082603",
            "telephone_number": "419-251-4724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 CHERRY ST FL",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43608",
            "telephone_number": "419-251-4724",
            "fax_number": "419-251-2698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 W 27th St",
            "address_purpose": "LOCATION",
            "city": "Lumberton",
            "state": "NC",
            "postal_code": "283583075",
            "country_code": "US",
            "telephone_number": "910-671-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAYVANDI",
        "first_name": "ALEXANDER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-24",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.015291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.