Individual provider Active NPI

Michelle Mirna Ariss, M.D.

  • Ophthalmology Physician
  • Sylvania, OH
National Provider Identifier
1407010101
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
35092138 Issued in OH
Practice address
5700 Monroe St Unit 211
Sylvania, OH 43560
Phone
(419) 776-1004
Fax
(419) 776-1020
NPI assigned
Jul 11, 2008
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 04-35739 KS
Ophthalmology Physician 207W00000X 2012018683 MO
Ophthalmology Physician 207W00000X 35092138 OH Primary

Addresses

Primary practice location

5700 Monroe St Unit 211
Sylvania, OH 43560

Mailing address

5700 Monroe St Unit 211
Sylvania, OH 43560-2737
Phone (419) 776-1004

Other practice location 1

2401 Gillham Rd
Department of Ophthalmology
Kansas City, MO 64108-4619
Phone (816) 234-3046

Other practice location 2

2401 Gillham Rd
Department of Ophthalmology
Kansas City, MO 64108-4619
Phone (816) 234-3046

Other identifiers 1

IdentifierTypeStateIssuer
2016160MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mariss21128@epicdirect.promedica.org

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
I20080911000307 OH Practitioner - Ophthalmology 3971679192 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-35739KSMDOphthalmology Physician
35092138OHMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians Ophthalmology CurrentSince Sep 1, 2019 Accepting new patients
Promedica Central Physicians CurrentSince Sep 1, 2019 Accepting new patients

Locations

5700 Monroe St
Sylvania, OH 43560
Phone (419) 473-6622

5700 Monroe St
Unit 211
Sylvania, OH 43560
Phone (419) 776-1004

5700 Monroe St
Unit 221
Sylvania, OH 43560

1 Seagate
#800
Toledo, OH 43604
Phone (567) 585-1964

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

2865 N Reynolds Rd
Toledo, OH 43615
Phone (419) 578-2700

2865 N Reynolds Rd
Ste 170
Toledo, OH 43615
Phone (419) 578-7036

Interoperability endpoints

  • Direct secure messaging: mariss21128@direct.promedica.org

Organizations & group practices 2

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": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1407010101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 MONROE ST UNIT 211",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602737",
            "telephone_number": "419-776-1004",
            "fax_number": "419-776-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 MONROE ST UNIT 211",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "43560",
            "telephone_number": "419-776-1004",
            "fax_number": "419-776-1020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 Gillham Rd",
            "address_2": "Department of Ophthalmology",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641084619",
            "country_code": "US",
            "telephone_number": "816-234-3046",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2401 Gillham Rd",
            "address_2": "Department of Ophthalmology",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641084619",
            "country_code": "US",
            "telephone_number": "816-234-3046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARISS",
        "first_name": "MICHELLE",
        "middle_name": "MIRNA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-11",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "KS",
            "license": "04-35739",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "2012018683",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35092138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2016160",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mariss21128@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.