Individual provider Active NPI

Ronald Joseph Pedalino, D.O

  • Surgery Physician
  • Wilmington, OH
National Provider Identifier
1184690257
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
34-003101 Issued in OH
Practice address
610 W Main St
Wilmington, OH 45177-2125
Phone
(937) 283-9970
NPI assigned
Feb 27, 2006
Last updated
Nov 9, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 34-003101 OH Primary

Addresses

Primary practice location

610 W Main St
Wilmington, OH 45177-2125

Mailing address

610 W Main St
Wilmington, OH 45177-2125
Phone (937) 283-9970

Other identifiers 1

IdentifierTypeStateIssuer
0448519MedicaidOH

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
I20040423001006 OH Practitioner - General Surgery 6901892975 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34-003101OHMDSurgery Physician
3101OHMDPhysical Therapy Assistant

Interoperability endpoints

  • Direct secure messaging: ropedali@yourcarecommunity.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1184690257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 W MAIN ST",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451772125",
            "telephone_number": "937-283-9970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 W MAIN ST",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451772125",
            "telephone_number": "937-283-9970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDALINO",
        "first_name": "RONALD",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "34-003101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0448519",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, OH

Sources for this page

Verify at the official NPI Registry.