Individual provider Active NPI

Paul A Taiganides, M.D.

  • Surgery Physician
  • Mount Vernon, OH
National Provider Identifier
1467457291
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME128502 Issued in FL
Practice address
1451 Yauger Road
Ste 2a
Mount Vernon, OH 43050
Phone
(740) 393-9024
Fax
(740) 393-9411
NPI assigned
Jun 17, 2005
Last updated
Nov 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME128502 FL Primary

Addresses

Primary practice location

1451 Yauger Road
Ste 2a
Mount Vernon, OH 43050

Mailing address

519 Medical Oaks Ave
Brandon, FL 33511-5961
Phone (740) 393-6585

Other identifiers 2

IdentifierTypeStateIssuer
2066231MedicaidOH
000000514280OtherOHANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Professional Alliance, LLC Surgery CurrentSince Jul 5, 2020 Accepting new patients
Deming Clinic Corporation Past Accepting new patients
Licking Memorial Professional Corporation Past Accepting new patients

Locations

519 Medical Oaks Ave
Brandon, FL 33511
Phone (813) 657-1414

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1596/brand/1/csg/43/fhir/r4

Organizations & group practices 3

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": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1467457291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 MEDICAL OAKS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115961",
            "telephone_number": "740-393-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 YAUGER ROAD",
            "address_2": "STE 2A",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "43050",
            "telephone_number": "740-393-9024",
            "fax_number": "740-393-9411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAIGANIDES",
        "first_name": "PAUL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME128502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2066231",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000514280",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.