Individual provider Active NPI

Alexandra Mouch, MD

  • Surgery Physician
  • Maumee, OH
National Provider Identifier
1679152912
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35.156051 Issued in OH
Practice address
5705 Monclova Rd Ste 204
Maumee, OH 43537-1877
Phone
(567) 302-6690
Fax
(567) 440-6940
NPI assigned
Apr 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4351048016 MI
Surgery Physician 208600000X 35.156051 OH Primary

Addresses

Primary practice location

5705 Monclova Rd Ste 204
Maumee, OH 43537-1877

Mailing address

5705 Monclova Rd Ste 204
Maumee, OH 43537-1877

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20210628002253 MI Order and Referring Only - General SurgeryPractitioner - General Surgery 1355742305

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1679152912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5705 MONCLOVA RD STE 204",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5705 MONCLOVA RD STE 204",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371877",
            "telephone_number": "567-302-6690",
            "fax_number": "567-440-6940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUCH",
        "first_name": "ALEXANDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4351048016",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35.156051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

Verify at the official NPI Registry.