Active NPI
Surgical Specialists of Bowling Green LLC
- Surgery Physician
- Bowling Green, OH
National Provider Identifier
1649435835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 35066329B
- Legal business name
- SURGICAL SPECIALISTS OF BOWLING GREEN LLC
- Practice address
- 960 W Wooster St
Suite 202
Bowling Green, OH 43402-2644 - Phone
- (419) 352-9124
- Fax
- (419) 353-7334
- NPI assigned
- Jul 28, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Michael J Bielefeld, MD
- Title
- Physician/Partner
- Phone
- (419) 352-9124
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 35066329B | OH | Primary |
Addresses
Primary practice location
960 W Wooster St
Suite 202
Bowling Green, OH 43402-2644
Mailing address
960 W Wooster St Ste 208
Bowling Green, OH 43402-2650
Phone (419) 352-9124
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DO3187 | Other | OH | RR MEDICARE |
| 2860980 | Medicaid | OH |
National Provider Directory
National Provider DirectoryLocations
960 W Wooster St
Ste 208
Bowling Green, OH 43402
Phone (419) 352-9124
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217203200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1570579200000",
"number": "1649435835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "960 W WOOSTER ST STE 208",
"city": "BOWLING GREEN",
"state": "OH",
"postal_code": "434022650",
"telephone_number": "419-352-9124",
"fax_number": "419-353-7334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "960 W WOOSTER ST",
"address_2": "SUITE 202",
"city": "BOWLING GREEN",
"state": "OH",
"postal_code": "434022644",
"telephone_number": "419-352-9124",
"fax_number": "419-353-7334"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SURGICAL SPECIALISTS OF BOWLING GREEN LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-07-28",
"last_updated": "2019-10-09",
"status": "A",
"authorized_official_last_name": "BIELEFELD",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "PHYSICIAN/PARTNER",
"authorized_official_telephone_number": "419-352-9124",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery",
"state": "OH",
"license": "35066329B",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "DO3187",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2860980",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bowling Green, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.