NPIMap

Organization Active NPI

Promedica Children's Specialists

  • Pediatrics Physician
  • Toledo, OH
National Provider Identifier
1245444959
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PROMEDICA CHILDREN'S SPECIALISTS
Doing business as
ProMedica Children's Specialists
Practice address
100 Madison Ave
MSC-S38805
Toledo, OH 43604-1531
Phone
(567) 585-1969
NPI assigned
May 10, 2007
Last updated
Sep 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Authorized official

Name
Tanya Wines
Title
Director
Phone
(567) 585-0422

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X
Pediatrics Physician 208000000X OH Primary
Developmental - Behavioral Pediatrics Physician 2080P0006X
Pediatric Cardiology Physician 2080P0202X
Pediatric Critical Care Medicine Physician 2080P0203X
Pediatric Endocrinology Physician 2080P0205X
Pediatric Gastroenterology Physician 2080P0206X
Pediatric Hematology & Oncology Physician 2080P0207X
Pediatric Surgery Physician 2086S0120X

Addresses

Primary practice location

100 Madison Ave
MSC-S38805
Toledo, OH 43604-1531

Mailing address

100 Madison Ave
Toledo, OH 43604-1516
Phone (844) 373-0871

Other identifiers 1

IdentifierTypeStateIssuer
2763620MedicaidOH

Other names 1

  • ProMedica Children's Specialists Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071204000485 OH Part B Supplier - Clinic/Group Practice 6709975345 Receives reassigned benefits from 77 practitioners
Practice locations: Toledo, OH

National Provider Directory

National Provider Directory

Locations

1001 Bellefontaine Ave
Fl 2
Lima, OH 45804
Phone (419) 291-2719

2120 W Central Ave
Toledo, OH 43606
Phone (419) 531-8558

2150 W Central Ave
#2
Toledo, OH 43606
Phone (291) 419-7919

Practitioners & affiliated clinicians

Practitioners 114

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 114

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757030400000",
    "number": "1245444959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MADISON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041516",
            "telephone_number": "844-373-0871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MADISON AVE",
            "address_2": "MSC-S38805",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041531",
            "telephone_number": "567-585-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMEDICA CHILDREN'S SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A",
        "authorized_official_last_name": "WINES",
        "authorized_official_first_name": "TANYA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "567-585-0422"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2763620",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Children's Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 5, 2025; 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.