NPIMap

Individual provider Active NPI

Stacy Bowen, D.O.

  • Family Medicine Physician
  • Toledo, OH
National Provider Identifier
1295717338
Registry record updated May 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34005713 Issued in OH
Practice address
4126 N Holland Sylvania Rd
Suite 220
Toledo, OH 43623-3536
Phone
(419) 517-7600
Fax
(419) 517-7610
NPI assigned
Nov 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2015

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 34005713 OH Primary

Addresses

Primary practice location

4126 N Holland Sylvania Rd
Suite 220
Toledo, OH 43623-3536

Mailing address

4126 N Holland Sylvania Rd
Suite 220
Toledo, OH 43623-3536
Phone (419) 517-7600

Other identifiers 4

IdentifierTypeStateIssuer
P00898628OtherOHRAILROAD MEDICARE
0148441MedicaidOH
P00051186OtherOHRAILROAD MEDICARE
4524106MedicaidMI

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
I20100422000532 OH Practitioner - Family Practice 4385532811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio University, College of Osteopathic Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Health Physicians-North LLC 131 clinicians

Practice addresses (Care Compare)

4126 N Holland Sylvania Rd
Suite 220
Toledo, OH 43623-3537
Phone (419) 473-9500

Hospital & facility affiliations

  • Ohioans Home Healthcare, Inc Home health agency, Perrysburg, OH, CCN 368247
  • Ohio Living Home Health Greater Toledo Home health agency, Toledo, OH, CCN 367530
  • Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112
  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34005713OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians-North LLC Family Medicine CurrentSince Feb 1, 2011 Accepting new patients
Mercy Health Physicians - North, LLC CurrentSince Feb 1, 2011 Accepting new patients
Comprehensive Care Family Practice, P.C. Family Medicine PastSince Apr 7, 2003 Accepting new patients
The Orthopaedic Network, Inc. Past Accepting new patients
Primary Care Center Inc Family Medicine Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Mercy Health System Northern Past Accepting new patients

Locations

7640 Sylvania Ave
Ste E
Sylvania, OH 43560
Phone (419) 473-2273

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

4126 N Holland Sylvania Rd
Ste 100
Toledo, OH 43623
Phone (419) 473-9500

4126 N Holland Sylvania Rd
Ste 220
Toledo, OH 43623
Phone (419) 517-7600

Interoperability endpoints

  • Direct secure messaging: sbowen26990@direct.bsmhealth.org

Organizations & group practices 7

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 5

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432252800000",
    "number": "1295717338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4126 N HOLLAND SYLVANIA RD",
            "address_2": "SUITE 220",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436233536",
            "telephone_number": "419-517-7600",
            "fax_number": "419-517-7610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4126 N HOLLAND SYLVANIA RD",
            "address_2": "SUITE 220",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436233536",
            "telephone_number": "419-517-7600",
            "fax_number": "419-517-7610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "STACY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2015-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34005713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00898628",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0148441",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00051186",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4524106",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.