NPIMap

Individual provider Active NPI

Ronald C Carissimi, M.D.

  • Family Medicine Physician
  • Amherst, OH
National Provider Identifier
1407068703
Registry record updated Jan 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35063090 Issued in OH
Practice address
101 Cooper Foster Park Rd
Amherst, OH 44001-1001
Phone
(440) 988-3705
Fax
(440) 988-7433
NPI assigned
May 7, 2007
Last updated
Jan 22, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2015

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 35063090 OH Primary

Addresses

Primary practice location

101 Cooper Foster Park Rd
Amherst, OH 44001-1001

Mailing address

PO Box 636643
Cincinnati, OH 45263-6643
Phone (440) 989-3801

Other identifiers 2

IdentifierTypeStateIssuer
0898382MedicaidOH
3025372MedicaidOH

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
I20100615000468 OH Practitioner - Family Practice 6103956305 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wright State University Boonshoft School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Health Physicians Lorain LLCGroup PAC ID 1355474172, 41 clinicians

Practice addresses (Care Compare)

578 N Leavitt Rd
Amherst, OH 44001-1131
Phone (440) 988-5226

5940 Oak Point Rd
Lorain, OH 44053-4100
Phone (440) 988-3705

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
35063090OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Lorain, LLC Family Medicine CurrentSince Sep 12, 2010 Accepting new patients
Mercy Health Physicians Lorain Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians, Lorain, LLC CurrentSince Sep 12, 2010 Accepting new patients
Mercy Health Physicians Lorain Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients

Locations

101 Cooper Foster Park Rd
Amherst, OH 44001
Phone (440) 365-7014

1957 Cooper Foster Park Rd
Amherst, OH 44001
Phone (440) 989-3801

578 N Leavitt Rd
Amherst, OH 44001
Phone (440) 960-3912

1480 Center Rd
Ste A
Avon, OH 44011
Phone (440) 934-4600

1120 E Broad St
Elyria, OH 44035
Phone (440) 365-2600

Interoperability endpoints

  • Direct secure messaging: rcarissimi41688@direct.bsmhealth.org

Organizations & group practices 4

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 4

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": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421884800000",
    "number": "1407068703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636643",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636643",
            "telephone_number": "440-989-3801",
            "fax_number": "440-960-0264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 COOPER FOSTER PARK RD",
            "city": "AMHERST",
            "state": "OH",
            "postal_code": "440011001",
            "telephone_number": "440-988-3705",
            "fax_number": "440-988-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARISSIMI",
        "first_name": "RONALD",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2015-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35063090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0898382",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3025372",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, OH

Sources for this page

Verify at the official NPI Registry.