Sanjiv Bais, MD
Individual provider Active NPI Surgery Physician · Toledo, OH
NPI 1528065315 · NPPES record last updated Jun 20, 2011
Key facts
- NPI
- 1528065315
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- 35067127B (OH)
- Practice address
- 4235 Secor Rd
Toledo, OH 43623-4231 - Phone
- (419) 479-5713
- NPI assigned
- Jul 7, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Colorectal Surgery (Proctology)
- Education
- Perelman School of Med at the University of Pennsylvania, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Toledo Clinic Incorporated
Mercy Health Physicians North Specialty Care LLC
Practice addresses (Care Compare)
4235 Secor Rd
Toldeo, OH 43623-4231
Phone (419) 479-5398
7640 Sylvania Ave
Suite a 1
Sylvania, OH 43560-9263
Phone (419) 251-4790
Hospital & facility affiliations
- Mercy St Vincent Medical Center
- Promedica Toledo Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 46 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 1-10 |
| Melanoma (skin cancer) excision | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040316000322 | OH | Practitioner - Colorectal Surgery (Proctology) |
8527958578 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35067127B | OH | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Toledo Clinic Incorporated | Current | Accepting new patients | |
| Wood Health Company LLC | Current |
Accepting new patients | |
| Mercy Health Physicians North Specialty Care LLC | Surgery | Current |
Accepting new patients |
| Toledo Clinic Incorporated | Surgery | Current |
Accepting new patients |
| Toledo Clinic Incorporated | Current |
Accepting new patients | |
| Mercy Health Physicians North Specialty Care LLC | Current |
Accepting new patients | |
| Toledo Clinic Incorporated | Past | Accepting new patients | |
| Mercy Health - St Vincent Medical Center LLC | Past | Accepting new patients |
Locations
970 W Wooster St
Rm 129
Bowling Green, OH 43402
Phone (419) 353-1239
950 W Wooster St
Bowling Green, OH 43402
Phone (419) 354-8900
745 Haskins Rd
Ste B
Bowling Green, OH 43402
Phone (419) 373-7607
141 N Keyser Ave
Deshler, OH 43516
Phone (419) 278-2065
1200 Medical Center Pkwy
Maumee, OH 43537
Phone (419) 794-7720
615 Fulton St
Ste A
Port Clinton, OH 43452
7640 Sylvania Ave
Ste A-1
Sylvania, OH 43560
Phone (419) 251-4790
7640 Sylvania Ave
Sylvania, OH 43560
Phone (419) 407-3340
4235 Secor Rd
Toledo, OH 43623
Phone (419) 214-4214
2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111
3404 W Sylvania Ave
Toledo, OH 43623
Phone (419) 407-1422
3900 Sunforest Ct
Ste 240
Toledo, OH 43623
Phone (419) 472-3126
2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013
Interoperability endpoints
- sanjiv.bais@toledoclinic.eclinicaldirectplus.com
- sbais109179@direct.bsmhealth.org
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 35067127B | OH | Yes |
Addresses
Primary practice location
4235 Secor Rd
Toledo, OH 43623-4231
Mailing address
4235 Secor Rd
Toledo, OH 43623-4231
Phone (419) 479-5713
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0976896 | Medicaid | OH |
Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.