Organization Active NPI

Surgical Specialists of Bowling Green LLC

  • Surgery Physician
  • Bowling Green, OH
National Provider Identifier
1649435835
Registry record updated Oct 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35066329B Issued in OH
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

Updated by the provider on Oct 9, 2019

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)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
DO3187OtherOHRR MEDICARE
2860980MedicaidOH

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.