NPIMap

Organization Active NPI

RS Medical Group PC

Doing business as Maumee Health and Wellness

  • General Practice Physician
  • Maumee, OH
National Provider Identifier
1558535807
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
35068996 Issued in OH
Legal business name
RS MEDICAL GROUP PC
Doing business as
Maumee Health and Wellness
Practice address
3355 Briarfield Blvd Ste E
Maumee, OH 43537-0238
Phone
(419) 868-3788
Fax
(419) 868-3829
NPI assigned
Apr 17, 2008
Last updated
Apr 4, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
RS MEDICAL GROUP PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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

Authorized official

Name
Dr. Krishna M Ragothaman, MDNPI 1295738235
Title
President
Phone
(419) 868-3788

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 35068996 OH Primary

Addresses

Primary practice location

3355 Briarfield Blvd Ste E
Maumee, OH 43537-0238

Mailing address

PO Box 238
3355 Briarfield Blvd Ste E
Maumee, OH 43537-0238
Phone (419) 868-3788

Other names 1

  • Maumee Health and Wellness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081115000060 OH Part B Supplier - Clinic/Group Practice 3375501240 Receives reassigned benefits from 6 practitioners
Practice locations: Oak Harbor, OH; Maumee, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D1053945Maumee Health and Wellness3355 Briarfield Blvd Suite E, Maumee, OH 43537Certificate of waiverMay 8, 2028

National Provider Directory

National Provider Directory
Tax ID family
RS Medical Group3 organizations share this tax ID, including this one
Part of
RS Medical Group

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554336000000",
    "number": "1558535807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 238",
            "address_2": "3355 BRIARFIELD BLVD STE E",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435370238",
            "telephone_number": "419-868-3788",
            "fax_number": "419-868-3829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 BRIARFIELD BLVD STE E",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435370238",
            "telephone_number": "419-868-3788",
            "fax_number": "419-868-3829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RS MEDICAL GROUP PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RS MEDICAL GROUP PC",
        "enumeration_date": "2008-04-17",
        "last_updated": "2019-04-04",
        "status": "A",
        "authorized_official_last_name": "RAGOTHAMAN",
        "authorized_official_first_name": "KRISHNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-868-3788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OH",
            "license": "35068996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maumee Health and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maumee, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.