Individual provider Active NPI

Robert James Kiffmeyer, PA-C

  • Surgical Physician Assistant
  • Upper Sandusky, OH
National Provider Identifier
1487699781
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
50-002433 Issued in OH
Practice address
885 N Sandusky Ave
Upper Sandusky, OH 43351-1098
Phone
(419) 294-4991
Fax
(419) 209-0278
NPI assigned
Jun 19, 2006
Last updated
Dec 15, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 50-002433 OH Primary

Addresses

Primary practice location

885 N Sandusky Ave
Upper Sandusky, OH 43351-1098

Mailing address

885 N Sandusky Ave
Upper Sandusky, OH 43351-1031
Phone (419) 294-4991

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rkiffmeyer805626@direct.mercy.com

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
I20060705000169 OH Practitioner - Physician Assistant 2163434432 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wyandot Memorial HospitalGroup PAC ID 1557340189, 70 clinicians

Practice addresses (Care Compare)

885 N Sandusky Ave
Upper Sandusky, OH 43351-1031
Phone 41929449912157

885 N Sandusky Ave
Upper Sandusky, OH 43351-1098

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50-002433OHMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wyandot Memorial Hospital CurrentSince Dec 1, 2025 Accepting new patients
Wyandot Memorial Hospital CurrentSince Nov 23, 2014 Accepting new patients
Wyandot Memorial Hospital Past Accepting new patients

Locations

27 St Lawrence Dr
Ste 102
Tiffin, OH 44883
Phone (419) 448-7424

885 N Sandusky Ave
Upper Sandusky, OH 43351
Phone (419) 294-4991

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.

Hospital & facility affiliations 1

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": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1487699781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 N SANDUSKY AVE",
            "city": "UPPER SANDUSKY",
            "state": "OH",
            "postal_code": "433511031",
            "telephone_number": "419-294-4991",
            "fax_number": "419-294-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 N SANDUSKY AVE",
            "city": "UPPER SANDUSKY",
            "state": "OH",
            "postal_code": "433511098",
            "telephone_number": "419-294-4991",
            "fax_number": "419-209-0278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIFFMEYER",
        "first_name": "ROBERT",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50-002433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkiffmeyer805626@direct.mercy.com",
            "affiliation": "N",
            "address_1": "885 N Sandusky Ave",
            "city": "Upper Sandusky",
            "state": "OH",
            "country_code": "US",
            "postal_code": "433511098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Upper Sandusky, OH

Sources for this page

Verify at the official NPI Registry.