Organization Active NPI

Michael J Bielefeld MD LLC

  • Surgery Physician
  • Fostoria, OH
National Provider Identifier
1508062589
Registry record updated Oct 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35-06-6329B Issued in OH
Legal business name
MICHAEL J BIELEFELD MD LLC
Practice address
501 Van Buren St
Suite 202
Fostoria, OH 44830-1534
Phone
(419) 436-8200
Fax
(419) 436-0077
NPI assigned
Jun 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2008

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

Authorized official

Name
Dr. Michael J Bielefeld, MD
Title
Physician Owner
Phone
(419) 436-8200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 35-06-6329B OH Primary

Addresses

Primary practice location

501 Van Buren St
Suite 202
Fostoria, OH 44830-1534

Mailing address

501 Van Buren St
Suite 202
Fostoria, OH 44830-1534
Phone (419) 436-8200

Other identifiers 1

IdentifierTypeStateIssuer
0977126MedicaidOH

National Provider Directory

National Provider Directory

Locations

501 Van Buren St
Ste 202
Fostoria, OH 44830
Phone (419) 436-1035

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223424000000",
    "number": "1508062589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 VAN BUREN ST",
            "address_2": "SUITE 202",
            "city": "FOSTORIA",
            "state": "OH",
            "postal_code": "448301534",
            "telephone_number": "419-436-8200",
            "fax_number": "419-436-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 VAN BUREN ST",
            "address_2": "SUITE 202",
            "city": "FOSTORIA",
            "state": "OH",
            "postal_code": "448301534",
            "telephone_number": "419-436-8200",
            "fax_number": "419-436-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J BIELEFELD MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2008-10-08",
        "status": "A",
        "authorized_official_last_name": "BIELEFELD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "419-436-8200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "OH",
            "license": "35-06-6329B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0977126",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fostoria, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; 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.