NPIMap

Organization Active NPI

Ohio Podiatric Physicians and Surgeons Group, LLC

  • Primary Podiatric Medicine Podiatrist
  • Maumee, OH
National Provider Identifier
1508264680
Registry record updated Dec 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
36003428 Issued in OH
Legal business name
OHIO PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC
Practice address
5757 Monclova Rd
Suite 5
Maumee, OH 43537-1863
Phone
(419) 893-5757
Fax
(419) 893-5399
NPI assigned
Dec 5, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2014

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

Authorized official

Name
Beau Gregory Bortel, DPMNPI 1952415101
Title
Physician
Phone
(419) 893-5757

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213EP1101X 36003428 OH Primary
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X 36003428 OH
Foot Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0131X 36003428 OH

Addresses

Primary practice location

5757 Monclova Rd
Suite 5
Maumee, OH 43537-1863

Mailing address

5757 Monclova Rd
Suite 5
Maumee, OH 43537-1863
Phone (419) 893-5757

National Provider Directory

National Provider Directory
Tax ID family
Ohio Podiatric Physicians and Surgeons Group LLC40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

Organizations that report the same tax identification number in the National Provider Directory.

View all 39

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1417737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417737600000",
    "number": "1508264680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5757 MONCLOVA RD",
            "address_2": "SUITE 5",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371863",
            "telephone_number": "419-893-5757",
            "fax_number": "419-893-5399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 MONCLOVA RD",
            "address_2": "SUITE 5",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371863",
            "telephone_number": "419-893-5757",
            "fax_number": "419-893-5399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-05",
        "last_updated": "2014-12-05",
        "status": "A",
        "authorized_official_last_name": "BORTEL",
        "authorized_official_first_name": "BEAU",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "419-893-5757",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "OH",
            "license": "36003428",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36003428",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "OH",
            "license": "36003428",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2014; 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.