Individual provider Active NPI

Phillip Arthur Immesoete II, MD

  • Neurological Surgery Physician
  • Pickerington, OH
National Provider Identifier
1609089317
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
35.090300 Issued in OH
Practice address
1509 Stonecreek Dr S
Pickerington, OH 43147-9836
Phone
(740) 653-2500
Fax
(740) 653-2552
NPI assigned
May 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 35.090300 OH Primary

Addresses

Primary practice location

1509 Stonecreek Dr S
Pickerington, OH 43147-9836

Mailing address

7951 Shoal Creek Blvd Ste 300
Austin, TX 78757-7582
Phone (512) 584-8404

Other practice location 1

335 Glessner Ave Fl Mob2
Mansfield, OH 44903-2269
Phone (567) 241-7700

Other practice location 2

770 W High St Ste 160
Lima, OH 45801-5900
Phone (419) 995-4960

Other practice location 3

5040 Forest Dr Ste 240
New Albany, OH 43054-8166
Phone (740) 653-2500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pimmesoete708852@direct.ohiohealth.com OhioHealth Physician Group, Inc.

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
I20240208004420 OH Practitioner - Neurosurgery 3870673643 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians
Mercy Health Physicians Lima Specialty Care LLCGroup PAC ID 7012332364, 254 clinicians

Practice addresses (Care Compare)

335 Glessner Ave
Mansfield, OH 44903-2269
Phone (419) 526-8581

770 W High St
Suite 160
Lima, OH 45801-5900
Phone (419) 996-5224

Hospital & facility affiliations

  • Mercy Health St Ritas Medical Center Hospital, Lima, OH, CCN 360066

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.090300OHMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Lima Specialty Care LLC CurrentSince Oct 27, 2024 Accepting new patients
Ohiohealth Corporation Neurological Surgery CurrentSince Dec 26, 2023 Accepting new patients
Ohiohealth Corporation CurrentSince Dec 26, 2023 Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

830 W High St
Ste 390
Lima, OH 45801
Phone (419) 995-4960

770 W High St
Ste 160
Lima, OH 45801
Phone (419) 996-5224

335 Glessner Ave
Mansfield, OH 44903
Phone (419) 522-0320

335 Glessner Ave
Fl MOB2
Mansfield, OH 44903
Phone (567) 241-7037

1509 Stonecreek Dr S
Pickerington, OH 43147
Phone (740) 653-2500

Interoperability endpoints

  • Direct secure messaging: pimmesoete223221@direct.bsmhealth.org

Organizations & group practices 3

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1609089317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7951 SHOAL CREEK BLVD STE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787577582",
            "telephone_number": "512-584-8404",
            "fax_number": "740-653-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 STONECREEK DR S",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "431479836",
            "telephone_number": "740-653-2500",
            "fax_number": "740-653-2552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "335 Glessner Ave Fl Mob2",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "OH",
            "postal_code": "449032269",
            "country_code": "US",
            "telephone_number": "567-241-7700",
            "fax_number": "567-241-7719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "770 W High St Ste 160",
            "address_purpose": "LOCATION",
            "city": "Lima",
            "state": "OH",
            "postal_code": "458015900",
            "country_code": "US",
            "telephone_number": "419-995-4960",
            "fax_number": "419-995-4961",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5040 Forest Dr Ste 240",
            "address_purpose": "LOCATION",
            "city": "New Albany",
            "state": "OH",
            "postal_code": "430548166",
            "country_code": "US",
            "telephone_number": "740-653-2500",
            "fax_number": "740-653-2552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IMMESOETE",
        "first_name": "PHILLIP",
        "middle_name": "ARTHUR",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OH",
            "license": "35.090300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pimmesoete708852@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group, Inc.",
            "address_1": "335 Glessner Ave Fl Mob2",
            "city": "Mansfield",
            "state": "OH",
            "country_code": "US",
            "postal_code": "449032269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pickerington, OH

Sources for this page

Verify at the official NPI Registry.