Individual provider Active NPI

Michael Stierman, NP

  • Family Nurse Practitioner
  • Perrysburg, OH
National Provider Identifier
1194977900
Registry record updated Aug 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA10338-NP Issued in OH
Practice address
12780 Roachton Rd # 1
Perrysburg, OH 43551-1350
Phone
(419) 872-0777
Fax
(419) 872-2369
NPI assigned
Oct 13, 2008
Last updated
Aug 7, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X COA.10338-NP OH
Family Nurse Practitioner 363LF0000X COA10338-NP OH Primary

Addresses

Primary practice location

12780 Roachton Rd # 1
Perrysburg, OH 43551-1350

Mailing address

12780 Roachton Rd # 1
Perrysburg, OH 43551-1350
Phone (419) 872-0777

Other identifiers 1

IdentifierTypeStateIssuer
2905495MedicaidOH

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090318000095 OH Practitioner - Nurse Practitioner 5991862054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Associates IncGroup PAC ID 7113092917, 14 clinicians

Practice addresses (Care Compare)

12780 Roachton Rd
Perrysburg, OH 43551-1350
Phone (419) 872-0777

3141 Central Park W
Toledo, OH 43617-1083
Phone (419) 872-0777

Merit-based Incentive Payment System (MIPS)

Final score
91.2 of 100Reported as group
Quality
82.4
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA.10338-NPOHMDNurse Practitioner
COA10338-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates Inc CurrentSince Aug 1, 2012 Accepting new patients
Emergency Physicians of Northwest Ohio Inc. Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Observation Physicians of Northwest Ohio LLC PastSince Mar 21, 2021 Accepting new patients

Locations

12780 Roachton Rd
Perrysburg, OH 43551
Phone 4198720777107

12780 Roachton Rd
#1
Perrysburg, OH 43551
Phone 4198720777 ext. 107

12780 Roachton Rd
Ste 1
Perrysburg, OH 43551

3141 Central Park W
Toledo, OH 43617

Organizations & group practices 4

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": "1223856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344297600000",
    "number": "1194977900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12780 ROACHTON RD # 1",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435511350",
            "telephone_number": "419-872-0777",
            "fax_number": "419-872-2369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12780 ROACHTON RD # 1",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435511350",
            "telephone_number": "419-872-0777",
            "fax_number": "419-872-2369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIERMAN",
        "first_name": "MICHAEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-13",
        "last_updated": "2012-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA.10338-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA10338-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2905495",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

Verify at the official NPI Registry.