NPIMap

Individual provider Active NPI

Jacinta Catherine Eickholt, M.D.

  • Family Medicine Physician
  • Lima, OH
National Provider Identifier
1356500805
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.099945 Issued in OH
Practice address
3224 Jarvis Rd
Lima, OH 45807-2213
Phone
(419) 996-5757
Fax
(419) 996-5913
NPI assigned
Jun 9, 2008
Last updated
Jul 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 11014499A IN
Family Medicine Physician 207Q00000X 35.099945 OH Primary

Addresses

Primary practice location

3224 Jarvis Rd
Lima, OH 45807-2213

Mailing address

PO Box 636930
Cincinnati, OH 45263-0001
Phone (513) 981-5123

Other identifiers 1

IdentifierTypeStateIssuer
0074054MedicaidOH

Other names 1

  • Jacinta Catherine Borgelt Former name

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
I20121105000497 OH Practitioner - Family Practice 9739330515 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Toledo Medical College, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Lima Specialty Care LLCGroup PAC ID 7012332364, 254 clinicians
Mercy Health Physicians Lima, LLCGroup PAC ID 3375607351, 54 clinicians

Practice addresses (Care Compare)

3224 Jarvis Rd
Lima, OH 45807-2213
Phone (419) 996-5757

575 Ottawa Glandorf Rd
Suite 3
Ottawa, OH 45875-1932
Phone (419) 523-4449

770 W High St
Suite 450
Lima, OH 45801-3962
Phone (419) 996-5633

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11014499AINMDFamily Medicine Physician
35.099945OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Lima, LLC Family Medicine CurrentSince Nov 12, 2012 Accepting new patients
Mercy Health Physicians Lima Specialty Care LLC CurrentSince May 5, 2021 Accepting new patients
County of Putnam Office of Auditor CurrentSince Jan 19, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Trilogy Healthcare of Putnam, LLC Past Accepting new patients
Trilogy Healthcare of Putnam II, LLC Past Accepting new patients

Locations

3224 Jarvis Rd
Lima, OH 45807
Phone (419) 996-5757

770 W High St
Ste 450
Lima, OH 45801
Phone (419) 996-5069

830 W High St
Ste 390
Lima, OH 45801
Phone (419) 995-4960

147 Putnam Pkwy
Ottawa, OH 45875
Phone (419) 425-3158

575 E Ottawa Glandorf Rd
Ste 3
Ottawa, OH 45875
Phone (419) 523-4449

1010 Lincoln Hwy
Wapakoneta, OH 45895
Phone (419) 738-3711

Interoperability endpoints

  • Direct secure messaging: jeickholt62046@direct.bsmhealth.org

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Putnam County HomecareOttawa, OH, CCN 367076 Home health agency Corporate Director (100%)
W-2 Managing Employee (100%)		 Jul 1, 2013
Jul 1, 2013
Putnam County HospiceOttawa, OH, CCN 361594 Hospice Corporate Director (100%) Jul 1, 2013

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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.

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": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1356500805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636930",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452630001",
            "telephone_number": "513-981-5123",
            "fax_number": "513-981-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3224 JARVIS RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458072213",
            "telephone_number": "419-996-5757",
            "fax_number": "419-996-5913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EICKHOLT",
        "first_name": "JACINTA",
        "middle_name": "CATHERINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-09",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11014499A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.099945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0074054",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACINTA",
            "last_name": "BORGELT",
            "middle_name": "CATHERINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.