NPIMap

Individual provider Active NPI

Lance P Criblez, M.D.

  • Family Medicine Physician
  • Pandora, OH
National Provider Identifier
1174519342
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-08-3162-C Issued in OH
Practice address
202 Hilty Drive
Pandora, OH 45877-9703
Phone
(419) 384-3251
Fax
(419) 384-3269
NPI assigned
Sep 23, 2005
Last updated
Aug 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35-08-3162-C OH Primary

Addresses

Primary practice location

202 Hilty Drive
Pandora, OH 45877-9703

Mailing address

202 Hilty Drive
PO Box 299
Pandora, OH 45877-0299
Phone (419) 384-3251

Other identifiers 1

IdentifierTypeStateIssuer
2430097MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031217000031 OH Practitioner - Family Practice 5597662650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wright State University Boonshoft School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pandora Family Physicians, Inc.Group PAC ID 8123001963, 5 clinicians

Practice addresses (Care Compare)

202 Hilty Dr
Pandora, OH 45877-9478
Phone (419) 384-3251

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions51
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pandora Family Physicians, Inc. Family Medicine CurrentSince Aug 1, 2004 Accepting new patients
Mary Rutan Hospital Family Medicine Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

202 Hilty Dr
Pandora, OH 45877
Phone (419) 384-3251

Interoperability endpoints

  • Direct secure messaging: admin@pandorafamilyphysicians.e-mdsdirect.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1174519342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 HILTY DRIVE",
            "address_2": "PO BOX 299",
            "city": "PANDORA",
            "state": "OH",
            "postal_code": "458770299",
            "telephone_number": "419-384-3251",
            "fax_number": "419-384-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 HILTY DRIVE",
            "city": "PANDORA",
            "state": "OH",
            "postal_code": "458779703",
            "telephone_number": "419-384-3251",
            "fax_number": "419-384-3269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIBLEZ",
        "first_name": "LANCE",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2022-08-10",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-08-3162-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2430097",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pandora, OH

Sources for this page

Verify at the official NPI Registry.