Individual provider Active NPI

Michael Demetrios Pappas, MD

  • Pediatric Critical Care Medicine Physician
  • Toledo, OH
National Provider Identifier
1518966407
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
66690 Issued in OH
Practice address
4405 N Holland Sylvania Rd
102
Toledo, OH 43623-2509
Phone
(419) 841-0772
Fax
(419) 841-0894
NPI assigned
Jul 21, 2005
Reactivated
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 66690 OH Primary
Pediatrics Physician 208000000X 66690 OH
Pediatric Critical Care Medicine Physician 2080P0203X 81657 AZ

Addresses

Primary practice location

4405 N Holland Sylvania Rd
102
Toledo, OH 43623-2509

Mailing address

4405 N Holland Sylvania Rd
102
Toledo, OH 43623-2509
Phone (419) 841-0772

Other practice location 1

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 213-6235

Other identifiers 1

IdentifierTypeStateIssuer
0971122MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20190401001779 MT Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 0345339883 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66690OHMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
RCHP Billings - Missoula LLC CurrentSince Feb 17, 2019 Accepting new patients
RCHP Billings - Missoula LLC CurrentSince Feb 17, 2019 Accepting new patients
Observation Physicians of Northwest Ohio LLC PastSince Mar 21, 2021 Accepting new patients
Children's Intensive Caring, Inc. Pediatrics Past Accepting new patients
Emergency Physicians of Northwest Ohio Inc. Past Accepting new patients

Locations

2827 Fort Missoula Rd
Fl 3
Missoula, MT 59804
Phone (406) 327-4237

2230 N Reserve St
Ste 402
Missoula, MT 59808
Phone (406) 327-3850

2230 N Reserve St
Missoula, MT 59808
Phone (406) 721-0533

2827 Fort Missoula Rd
Missoula, MT 59804
Phone (406) 327-4202

Interoperability endpoints

  • Direct secure messaging: michael.pappas@960197378899972.direct.elationemr.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1518966407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 N HOLLAND SYLVANIA RD",
            "address_2": "102",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436232509",
            "telephone_number": "419-841-0772",
            "fax_number": "419-841-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 N HOLLAND SYLVANIA RD",
            "address_2": "102",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436232509",
            "telephone_number": "419-841-0772",
            "fax_number": "419-841-0894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N Beaver St",
            "address_purpose": "LOCATION",
            "city": "Flagstaff",
            "state": "AZ",
            "postal_code": "860013118",
            "country_code": "US",
            "telephone_number": "928-213-6235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAPPAS",
        "first_name": "MICHAEL",
        "middle_name": "DEMETRIOS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "OH",
            "license": "66690",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "66690",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "AZ",
            "license": "81657",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0971122",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.