NPIMap

Individual provider Active NPI

Timothy Wayne Mummert, D.O.

  • Internal Medicine Physician
  • Port Clinton, OH
National Provider Identifier
1265426993
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
005235 Issued in OH
Practice address
2861 E Harbor Rd
Port Clinton, OH 43452-2665
Phone
(419) 734-5587
Fax
(419) 732-1553
NPI assigned
Sep 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 005235 OH Primary

Addresses

Primary practice location

2861 E Harbor Rd
Port Clinton, OH 43452-2665

Mailing address

2861 E Harbor Rd
Port Clinton, OH 43452-2665
Phone (419) 734-5587

Other identifiers 1

IdentifierTypeStateIssuer
0815461MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address timothy.mummert@direct.magruderhospital.com Direct

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
I20041116000090 OH Practitioner - Internal Medicine 6608830062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Magruder Medical Group LTDGroup PAC ID 1951675198, 13 clinicians

Practice addresses (Care Compare)

2861 E Harbor Rd
Port Clinton, OH 43452-2665
Phone (419) 734-5587

611 Fulton St
Port Clinton, OH 43452-2008

615 Fulton St
Port Clinton, OH 43452-2001

Hospital & facility affiliations

  • Ohioans Home Healthcare, Inc Home health agency, Perrysburg, OH, CCN 368247
  • Elara Caring Home health agency, Toledo, OH, CCN 367730
  • FRMC Home Health Services Home health agency, Sandusky, OH, CCN 367691
  • Guiding Hands Home Health Services, Inc Home health agency, Oak Harbor, OH, CCN 368427
  • Magruder Hospital Hospital, Port Clinton, OH, CCN 361314
  • Firelands Regional Medical Center Hospital, Sandusky, OH, CCN 360025

Merit-based Incentive Payment System (MIPS)

Final score
76.49 of 100Reported as group
Quality
55.95
Promoting interoperability
89
Improvement activities
40
Cost
74.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5235OHMDOptometrist
005235OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Magruder Medical Group LTD Internal Medicine CurrentSince Nov 1, 2017 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Hospital Medicine Associates of Ohio Professional Corporation Internal Medicine Past Accepting new patients
Incare LLC Internal Medicine Past Accepting new patients

Locations

611 Fulton St
Ste C
Port Clinton, OH 43452
Phone (419) 732-6500

2861 East Harbor Rd
Port Clinton, OH 43452
Phone (419) 732-1833

1250 Fulton St
Port Clinton, OH 43452
Phone (419) 734-0699

615 Fulton St
Port Clinton, OH 43452
Phone (419) 734-3131

Interoperability endpoints

  • Direct secure messaging: timothy.mummert@direct.magruderhospital.com

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 and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1265426993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2861 E HARBOR RD",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434522665",
            "telephone_number": "419-734-5587",
            "fax_number": "419-732-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2861 E HARBOR RD",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434522665",
            "telephone_number": "419-734-5587",
            "fax_number": "419-732-1553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUMMERT",
        "first_name": "TIMOTHY",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "005235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0815461",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "timothy.mummert@direct.magruderhospital.com",
            "affiliation": "N",
            "endpointDescription": "H.B. Magruder Hospital Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1250 Fulton St",
            "city": "Port Clinton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "434529296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Port Clinton, OH

Sources for this page

Verify at the official NPI Registry.