Individual provider Active NPI

Todd Michael Wiley, MD

  • Family Medicine Physician
  • Marysville, OH
National Provider Identifier
1295838134
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35079429W Issued in OH
Practice address
14210 Scottslawn Rd
Marysville, OH 43041-0001
Phone
(937) 578-5555
Fax
(937) 578-2642
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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 35079429W OH Primary

Addresses

Primary practice location

14210 Scottslawn Rd
Marysville, OH 43041-0001

Mailing address

14210 Scottslawn Rd
Marysville, OH 43041-0001
Phone (937) 578-5555

Other identifiers 1

IdentifierTypeStateIssuer
2280660MedicaidOH

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
I20090806000158 OH Practitioner - Family Practice 7416000526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Carolina School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Union County Physician CorporationGroup PAC ID 1557419173, 105 clinicians

Practice addresses (Care Compare)

14210 Scottslawn Rd
Marysville, OH 43041-0001
Phone (937) 578-5555

Hospital & facility affiliations

  • Memorial Hospital Hospital, Marysville, OH, CCN 360092

Merit-based Incentive Payment System (MIPS)

Final score
83.33 of 100Reported as group
Quality
68.93
Promoting interoperability
100
Improvement activities
40
Cost
75.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35079429WOHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union County Physician Corporation CurrentSince Apr 1, 2024 Accepting new patients
Union County Physician Corporation CurrentSince Apr 1, 2024 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Emergency Medicine of Indiana Past Accepting new patients
Emergency Physicians of Indiana PC Past Accepting new patients

Locations

388 Damascus Rd
Marysville, OH 43040
Phone (937) 578-2626

500 London Ave
Marysville, OH 43040
Phone (740) 420-8451

Interoperability endpoints

  • Direct secure messaging: twiley1182029@direct.osumc.edu

Organizations & group practices 5

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 1

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": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1295838134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14210 SCOTTSLAWN RD",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430410001",
            "telephone_number": "937-578-5555",
            "fax_number": "937-578-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14210 SCOTTSLAWN RD",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430410001",
            "telephone_number": "937-578-5555",
            "fax_number": "937-578-2642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "TODD",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2024-05-06",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35079429W",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2280660",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, OH

Sources for this page

Verify at the official NPI Registry.