Individual provider Active NPI

Manal G Isak

  • Family Nurse Practitioner
  • Toledo, OH
National Provider Identifier
1538649272
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.023427 Issued in OH
Practice address
3000 Arlington Ave
Toledo, OH 43614
Phone
(419) 383-3761
Fax
(419) 383-6255
NPI assigned
Aug 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704298547 MI
Family Nurse Practitioner 363LF0000X APRN.CNP.023427 OH Primary

Addresses

Primary practice location

3000 Arlington Ave
Toledo, OH 43614

Mailing address

3355 Glendale Ave FL 3
Toledo, OH 43614-2426
Phone (419) 383-3761

Other practice location 1

20217 Ann Arbor Trl
Dearborn Heights, MI 48127-2692
Phone (313) 395-3444

Other practice location 2

20217 Ann Arbor Trl
Dearborn Heights, MI 48127-2692
Phone (313) 395-3444

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190206002512 OH Practitioner - Nurse Practitioner 4880945765 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704298547MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians-North LLC CurrentSince Jun 1, 2020 Accepting new patients
Mercy Health Physicians North Specialty Care LLC Nurse Practitioner CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians - North, LLC CurrentSince Jun 1, 2020 Accepting new patients

Locations

2600 Navarre Ave
Oregon, OH 43616
Phone (419) 696-7200

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

3900 Sunforest Ct
Ste 240
Toledo, OH 43623
Phone (419) 472-3126

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.

NPI Registry JSON

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1538649272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 GLENDALE AVE FL 3",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436142426",
            "telephone_number": "419-383-3761",
            "fax_number": "419-383-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 ARLINGTON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43614",
            "telephone_number": "419-383-3761",
            "fax_number": "419-383-6255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20217 Ann Arbor Trl",
            "address_purpose": "LOCATION",
            "city": "Dearborn Heights",
            "state": "MI",
            "postal_code": "481272692",
            "country_code": "US",
            "telephone_number": "313-395-3444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20217 Ann Arbor Trl",
            "address_purpose": "LOCATION",
            "city": "Dearborn Heights",
            "state": "MI",
            "postal_code": "481272692",
            "country_code": "US",
            "telephone_number": "313-395-3444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISAK",
        "first_name": "MANAL",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-21",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704298547",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.023427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.