Individual provider Active NPI

Benjamin Timothy Forrester, DO

  • Psychiatry Physician
  • Wauseon, OH
National Provider Identifier
1386764702
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
34.008787 Issued in OH
Practice address
725 S Shoop Ave
Wauseon, OH 43567-1702
Phone
(419) 335-2015
NPI assigned
Mar 30, 2007
Last updated
Jun 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 34.008787 OH Primary

Addresses

Primary practice location

725 S Shoop Ave
Wauseon, OH 43567-1702

Mailing address

725 S Shoop Ave
Wauseon, OH 43567-1702
Phone (419) 335-2015

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address benjamin.forrester.p1@direct.whc.nextgenshare.com

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
I20070727000190 OH Practitioner - PsychiatryPractitioner - Osteopathic Manipulative Medicine 6800997354 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Osteopathic Manipulative Medicine
Education
Ohio University, College of Osteopathic Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wood Health Company LLCGroup PAC ID 7911800461, 61 clinicians

Practice addresses (Care Compare)

838 E Wooster St
Bowling Green, OH 43402-2601
Phone (419) 372-2271

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.008787OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Ohio Office of Budget and Management State Accounting Current Accepting new patients
State of Ohio Office of Budget and Management State Accounting CurrentSince Sep 28, 2015 Accepting new patients
State of Ohio Office of Budget and Management State Accounting CurrentSince Sep 28, 2015 Accepting new patients

Locations

30 E Broad St
Fl 11
Columbus, OH 43215
Phone (614) 466-9930

930 S Detroit Ave
Toledo, OH 43614
Phone (419) 381-1881

Interoperability endpoints

  • Direct secure messaging: benjamin.forrester.p1@direct.whc.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1386764702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 S SHOOP AVE",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435671702",
            "telephone_number": "419-335-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S SHOOP AVE",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435671702",
            "telephone_number": "419-335-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORRESTER",
        "first_name": "BENJAMIN",
        "middle_name": "TIMOTHY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "34.008787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "benjamin.forrester.p1@direct.whc.nextgenshare.com",
            "affiliation": "N",
            "address_1": "838 E Wooster St",
            "city": "Bowling Green",
            "state": "OH",
            "country_code": "US",
            "postal_code": "434023186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wauseon, OH

Sources for this page

Verify at the official NPI Registry.