Individual provider Active NPI

Bradley J Marzec, FNP

  • Family Nurse Practitioner
  • Lima, OH
National Provider Identifier
1477814523
Registry record updated Apr 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA.13388 Issued in OH
Practice address
770 W High St
Suite 160B
Lima, OH 45801-3990
Phone
(419) 996-5224
Fax
(419) 996-5276
NPI assigned
Jun 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X COA.13388 OH Primary

Addresses

Primary practice location

770 W High St
Suite 160B
Lima, OH 45801-3990

Mailing address

PO Box 636930
Cincinnati, OH 45263-0001
Phone (513) 981-5123

Other identifiers 1

IdentifierTypeStateIssuer
0066053MedicaidOH

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120619000277 OH Practitioner - Nurse Practitioner 3870757099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Lima Specialty Care LLCGroup PAC ID 7012332364, 254 clinicians

Practice addresses (Care Compare)

730 W Market St
Lima, OH 45801-4602
Phone (419) 226-4310

Hospital & facility affiliations

  • Mercy Health St Ritas Medical Center Hospital, Lima, OH, CCN 360066
  • Grand Lake Health System Hospital, Saint Marys, OH, CCN 360032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA.13388OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Lima Specialty Care LLC CurrentSince Sep 1, 2020 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Mercy Health-St Ritas Medical Center LLC Past Accepting new patients

Locations

770 W High St
Lima, OH 45801
Phone (419) 996-5240

770 W High St
Ste 160B
Lima, OH 45801
Phone (419) 996-5224

730 W Market St
Lima, OH 45801
Phone (419) 226-4310

770 W High St
Ste 160
Lima, OH 45801
Phone (419) 996-5224

770 W High St
Ste 450
Lima, OH 45801
Phone (419) 996-5069

830 W High St
Ste 390
Lima, OH 45801
Phone (419) 995-4960

750 W High St
Ste 240
Lima, OH 45801
Phone (419) 996-5037

Interoperability endpoints

  • Direct secure messaging: bmarzec57910@direct.bsmhealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460678400000",
    "number": "1477814523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636930",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452630001",
            "telephone_number": "513-981-5123",
            "fax_number": "513-981-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 W HIGH ST",
            "address_2": "SUITE 160B",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458013990",
            "telephone_number": "419-996-5224",
            "fax_number": "419-996-5276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARZEC",
        "first_name": "BRADLEY",
        "middle_name": "J",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-06",
        "last_updated": "2016-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.13388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0066053",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.