Individual provider Active NPI

Todd J Cooperider, M.D.

  • Anesthesiology Physician
  • Toledo, OH
National Provider Identifier
1538167499
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
03507927 Issued in OH
Practice address
2142 N Cove Blvd
Toledo, OH 43606-3895
Phone
(419) 471-4491
Fax
(419) 479-6905
NPI assigned
Jul 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 03507927 OH Primary

Addresses

Primary practice location

2142 N Cove Blvd
Toledo, OH 43606-3895

Mailing address

2914 S Republic Blvd
Toledo, OH 43615-1912
Phone (419) 531-8808

Other identifiers 4

IdentifierTypeStateIssuer
050065407OtherOHRAILROAD MEDICARE
0761117OtherOHBCMH
104071412OtherMIMICHIGAN MEDICAID
0761117MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tcooperider13765@epicdirect.promedica.org

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
I20120209000654 OH Practitioner - Anesthesiology 2860396579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Toledo Medical College, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

650 Beaver Creek Cir
Suite 130
Maumee, OH 43537-1753
Phone (419) 891-6210

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
03507927OHMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians CurrentSince Dec 31, 2015 Accepting new patients
Promedica Central Physicians CurrentSince Dec 31, 2015 Accepting new patients
Anesthesiology Consultants of Toledo, Inc Anesthesiology Past Accepting new patients
Consultants in Anesthesiology, Inc Anesthesiology Past Accepting new patients

Locations

501 Van Buren St
Fostoria, OH 44830
Phone (419) 435-7734

650 Beaver Creek Cir
Ste 130
Maumee, OH 43537
Phone (419) 891-6210

5200 Harroun Rd
Sylvania, OH 43560
Phone (419) 824-1305

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

1 Seagate
Ste 800
Toledo, OH 43604

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

2865 N Reynolds Rd
Ste 190
Toledo, OH 43615
Phone (419) 578-7500

Organizations & group practices 4

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": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1538167499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2914 S REPUBLIC BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436151912",
            "telephone_number": "419-531-8808",
            "fax_number": "419-531-9342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2142 N COVE BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063895",
            "telephone_number": "419-471-4491",
            "fax_number": "419-479-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPERIDER",
        "first_name": "TODD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "03507927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050065407",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCMH",
            "identifier": "0761117",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN MEDICAID",
            "identifier": "104071412",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0761117",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tcooperider13765@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.