NPIMap

Organization Active NPI

Toledo Clinic Incorporated

  • Surgery Physician
  • Toledo, OH
National Provider Identifier
1144217894
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
TOLEDO CLINIC INCORPORATED
Practice address
4235 Secor Rd
Toledo Clinic Inc
Toledo, OH 43623-4231
Phone
(419) 473-3561
NPI assigned
Sep 28, 2005
Last updated
Jun 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Authorized official

Name
Tom Sylak
Title
Chief Operating Officer
Phone
(419) 473-3561

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X NU
Clinical Medical Laboratory 291U00000X NU
Durable Medical Equipment & Medical Supplies 332B00000X NU
Allergy Physician 207KA0200X NU
Dermatology Physician 207N00000X NU
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Cardiovascular Disease Physician 207RC0000X NU
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU
Gastroenterology Physician 207RG0100X NU
Nephrology Physician 207RN0300X NU
Gynecology Physician 207VG0400X NU
Diagnostic Radiology Physician 2085R0202X NU
Surgery Physician 208600000X NU Primary
Colon & Rectal Surgery Physician 208C00000X NU

Addresses

Primary practice location

4235 Secor Rd
Toledo Clinic Inc
Toledo, OH 43623-4231

Mailing address

4235 Secor Rd
Toledo, OH 43623-4231
Phone (419) 473-3561

Other identifiers 1

IdentifierTypeStateIssuer
8822117MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031219000210 OH Part B Supplier - Clinic/Group Practice 5698673382 Receives reassigned benefits from 251 practitioners
3 other NPIs on this enrollment

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

960 W Wooster St
Ste 111
Bowling Green, OH 43402
Phone (419) 353-5419

2702 Navarre Ave
Ste 202
Oregon, OH 43616
Phone (419) 693-4151

1850 Eastgate Rd
Ste I
Toledo, OH 43614
Phone (419) 385-0002

4345 Secor Rd
Toledo, OH 43623
Phone (419) 469-6884

Practitioners & affiliated clinicians

Practitioners 267

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 267

NPI Registry JSON

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

{
    "created_epoch": "1127865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1144217894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234231",
            "telephone_number": "419-473-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "address_2": "TOLEDO CLINIC INC",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234231",
            "telephone_number": "419-473-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOLEDO CLINIC INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-28",
        "last_updated": "2024-06-04",
        "certification_date": "2024-01-12",
        "status": "A",
        "authorized_official_last_name": "SYLAK",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "419-473-3561"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8822117",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.