Benjamin Timothy Forrester, DO

Individual provider Active NPI Psychiatry Physician · Wauseon, OH

NPI 1386764702 · NPPES record last updated Jun 15, 2022

Key facts

NPI
1386764702
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatry Physician 2084P0800X
License
34.008787 (OH)
Practice address
725 S Shoop Ave
Wauseon, OH 43567-1702
Phone
(419) 335-2015
NPI assigned
Mar 30, 2007
Sex
Male
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Psychiatry
Also: 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 LLC (61 clinicians)

Practice addresses (Care Compare)

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20070727000190 OH Practitioner - Psychiatry
Practitioner - Osteopathic Manipulative Medicine
6800997354 Reassigns benefits to 3 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
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
since Sep 28, 2015
Accepting new 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 Current
since 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

Specialties & licenses

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

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

Other identifiers

IdentifierTypeStateIssuer
2966625MedicaidOH

Electronic endpoints

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

Other providers in Wauseon, OH

All providers in Wauseon, OH · Psychiatry Physician in Ohio

Sources for this page

Verify at the official NPI Registry.