Individual provider Active NPI

Michael C Gardner, MD

  • Pediatric Anesthesiology Physician
  • Elyria, OH
National Provider Identifier
1548528839
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
35.139521 Issued in OH
Practice address
860 E Broad St Ste 1
Elyria, OH 44035-6542
Phone
(440) 323-8515
NPI assigned
Apr 24, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Anesthesiology Physician 207LP3000X 35.139521 OH Primary
Anesthesiology Physician 207L00000X 35.139521 OH

Addresses

Primary practice location

860 E Broad St Ste 1
Elyria, OH 44035-6542

Mailing address

860 E Broad St Ste 1
Elyria, OH 44035-6542
Phone (440) 323-8515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200318000119 DC Practitioner - Anesthesiology 4486962917 Reassigns benefits to 1 organization
I20210811004117 OH Practitioner - Anesthesiology 4486962917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
George Washington University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elyria Anesthesia IncorporatedGroup PAC ID 7214902170, 64 clinicians

Practice addresses (Care Compare)

630 E River St
Elyria, OH 44035-5902
Phone (440) 323-8515

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Reston Anesthesia Associates, PC Anesthesiology CurrentSince Jan 12, 2020 Accepting new patients
Elyria Anesthesia Incorporated Anesthesiology CurrentSince Jul 26, 2021 Accepting new patients

Locations

860 E Broad St
Ste I
Elyria, OH 44035
Phone (440) 323-8458

630 E River St
Elyria, OH 44035
Phone (440) 329-7450

3700 Kolbe Rd
Lorain, OH 44053
Phone (440) 331-9520

200 W Lorain St
Oberlin, OH 44074
Phone (440) 775-1211

1850 Town Center Pkwy
Reston, VA 20190
Phone (703) 478-0922

Interoperability endpoints

  • Direct secure messaging: mgardner32944@ehrdirect.uhhospitals.org
  • Direct secure messaging: mgardner852836@direct.bsmhealth.org

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 3

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": "1335225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1548528839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 E BROAD ST STE 1",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356542",
            "telephone_number": "440-323-8515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 E BROAD ST STE 1",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356542",
            "telephone_number": "440-323-8515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-24",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "OH",
            "license": "35.139521",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35.139521",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

Verify at the official NPI Registry.