Individual provider Active NPI

Raymond Joseph Baddour, MD

  • Neurology Physician
  • Mansfield, OH
National Provider Identifier
1508875634
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
35-078415 Issued in OH
Practice address
370 Cline Ave
Ste C5
Mansfield, OH 44907-1057
Phone
(419) 756-6990
Fax
(419) 756-0944
NPI assigned
Aug 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 35-078415 OH Primary

Addresses

Primary practice location

370 Cline Ave
Ste C5
Mansfield, OH 44907-1057

Mailing address

370 Cline Ave
Ste C5
Mansfield, OH 44907-1057
Phone (419) 756-6990

Other practice location 1

1761 Beall Ave Fl 1
Wooster, OH 44691-2342
Phone (330) 263-8312

Other identifiers 5

IdentifierTypeStateIssuer
606176800OtherOHDEPT OF LABOR ID#
30022664OtherOHRAILROAD MEDICARE ID#
341934892001OtherOHMEDICAL MUTUAL GRP#
2877801MedicaidOH
000000182209OtherOHANTHEM PROV ID#

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100629000840 OH Practitioner - Neurology 3971634304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Ohio State University College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bloomington Medical Services LLCGroup PAC ID 9032297627, 106 clinicians

Practice addresses (Care Compare)

1761 Beall Ave
Suite 1
Wooster, OH 44691-2342
Phone (330) 262-2800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.09 of 100Reported as group
Quality
59.24
Promoting interoperability
99
Improvement activities
40
Cost
78.55

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-078415OHMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bloomington Medical Services LLC CurrentSince Feb 6, 2020 Accepting new patients
Ohio Rehab Center II, Inc Past Accepting new patients

Locations

1761 Beall Ave
Fl 1
Wooster, OH 44691
Phone (330) 263-8312

128 E Milltown Rd
Ste 101
Wooster, OH 44691
Phone (330) 262-0081

128 E Milltown Rd
Ste 201
Wooster, OH 44691
Phone (330) 263-8312

1761 Beall Ave
Ste 1
Wooster, OH 44691
Phone (303) 262-2800

1761 Beall Ave
Wooster, OH 44691
Phone (330) 263-8100

Interoperability endpoints

  • Direct secure messaging: raymond.baddour@bloomingtonmedical.medicity.net

Organizations & group practices 2

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 2

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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1508875634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 CLINE AVE",
            "address_2": "STE C5",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071057",
            "telephone_number": "419-756-6990",
            "fax_number": "419-756-0944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 CLINE AVE",
            "address_2": "STE C5",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071057",
            "telephone_number": "419-756-6990",
            "fax_number": "419-756-0944"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1761 Beall Ave Fl 1",
            "address_purpose": "LOCATION",
            "city": "Wooster",
            "state": "OH",
            "postal_code": "446912342",
            "country_code": "US",
            "telephone_number": "330-263-8312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BADDOUR",
        "first_name": "RAYMOND",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OH",
            "license": "35-078415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR ID#",
            "identifier": "606176800",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE ID#",
            "identifier": "30022664",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL GRP#",
            "identifier": "341934892001",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2877801",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROV ID#",
            "identifier": "000000182209",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

Verify at the official NPI Registry.