Mary-Helene A Massullo, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

34004036 Issued in OH

Practice address

501 Van Buren St
Suite 206
Fostoria, OH 44830-1534

Phone

(419) 436-1035

Fax

(419) 436-0765

NPI assigned

Dec 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

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.

• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431993600000",
    "number": "1649348343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 VAN BUREN ST",
            "address_2": "SUITE 206",
            "city": "FOSTORIA",
            "state": "OH",
            "postal_code": "448301534",
            "telephone_number": "419-436-1035",
            "fax_number": "419-436-0765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 VAN BUREN ST",
            "address_2": "SUITE 206",
            "city": "FOSTORIA",
            "state": "OH",
            "postal_code": "448301534",
            "telephone_number": "419-436-1035",
            "fax_number": "419-436-0765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSULLO",
        "first_name": "MARY-HELENE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2015-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "34004036",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OH",
            "license": "34004036",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0786252",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frank Magro, DO
• Jonathan Lincoln Mahler
• Lisa Markley, LSP
• Alexa Ray Martinez
• Komal Masood, M.D
• Sherrie L Mathias
• Teresa Mauko
• Denise Ann May, RPH
• Erica McMillon
• Faith McNeal, FNP

• Surgery Physician in Fostoria, OH
• Providers in Fostoria, OH by specialty
• Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.