Individual provider Active NPI

Edgar E Tolentino, MD

  • Surgery Physician
  • Parma, OH
National Provider Identifier
1639266539
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35034415 Issued in OH
Practice address
5500 Ridge Rd
Suite 115
Parma, OH 44129
Phone
(440) 743-0426
Fax
(440) 743-7466
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35034415 OH Primary

Addresses

Primary practice location

5500 Ridge Rd
Suite 115
Parma, OH 44129

Mailing address

5500 Ridge Rd
Suite 115
Parma, OH 44129
Phone (440) 743-0426

Other identifiers 1

IdentifierTypeStateIssuer
0199244MedicaidOH

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
I20061016000141 OH Practitioner - General SurgeryPractitioner - General PracticePractitioner - Family Practice 2860498862 Practice locations: Parma, OH

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35034415OHMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380240000000",
    "number": "1639266539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 RIDGE RD",
            "address_2": "SUITE 115",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "44129",
            "telephone_number": "440-743-0426",
            "fax_number": "440-743-7466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 RIDGE RD",
            "address_2": "SUITE 115",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "44129",
            "telephone_number": "440-743-0426",
            "fax_number": "440-743-7466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLENTINO",
        "first_name": "EDGAR",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2013-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35034415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0199244",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parma, OH

Sources for this page

Verify at the official NPI Registry.