NPIMap

Individual provider Active NPI

Robert L Neidich, MD

  • Gastroenterology Physician
  • Lima, OH
National Provider Identifier
1568433910
Registry record updated Oct 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
35068286 Issued in OH
Practice address
2793 Shawnee Rd
Lima, OH 45806-1444
Phone
(419) 227-8209
Fax
(419) 222-6007
NPI assigned
Feb 1, 2006
Last updated
Oct 9, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 35068286 OH Primary

Addresses

Primary practice location

2793 Shawnee Rd
Lima, OH 45806-1444

Mailing address

10 Ravine CT
Lima, OH 45805-4000
Phone (419) 999-1088

Other identifiers 1

IdentifierTypeStateIssuer
0165306MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050621001232 OH Practitioner - Gastroenterology 0345294997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Cincinnati College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gcga Physicians Inc.Group PAC ID 4284618224, 76 clinicians

Practice addresses (Care Compare)

140 Fox Rd
Suite 209
Van Wert, OH 45891-2492
Phone (419) 227-8209

2793 Shawnee Rd
Lima, OH 45806-1444
Phone (419) 227-8209

2925 Vernon PL
Cincinnati, OH 45219-2425

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy138
Upper gastrointestinal (GI) endoscopy for acid reflux264

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35068286OHMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Endoscopy Center of West Central Ohio, LLC Current Accepting new patients
Gcga Physicians Inc. Gastroenterology CurrentSince Oct 1, 2021 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

950 S Main St
Celina, OH 45822
Phone (419) 586-1611

2925 Vernon Pl
Ste 100
Cincinnati, OH 45219
Phone (513) 872-4555

1800 E 5th St
Delphos, OH 45833
Phone (419) 692-2662

2793 Shawnee Rd
Lima, OH 45806
Phone (419) 204-1501

140 Fox Rd
Ste 209
Van Wert, OH 45891
Phone (419) 222-6595

Interoperability endpoints

  • Direct secure messaging: robert.neidich@gastrohealth.eclinicaldirectplus.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223510400000",
    "number": "1568433910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 RAVINE CT",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458054000",
            "telephone_number": "419-999-1088",
            "fax_number": "419-222-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2793 SHAWNEE RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458061444",
            "telephone_number": "419-227-8209",
            "fax_number": "419-222-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEIDICH",
        "first_name": "ROBERT",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2008-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "35068286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0165306",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.