NPIMap

Individual provider Active NPI

Jeffrey A. Pruitt, M.D.

  • Surgery Physician
  • Defiance, OH
National Provider Identifier
1689656696
Registry record updated Mar 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35062785P Issued in OH
Practice address
1400 E 2ND St
Defiance, OH 43512-2440
Phone
(419) 784-1414
NPI assigned
Nov 16, 2005
Last updated
Mar 21, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2011

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 35062785P OH Primary

Addresses

Primary practice location

1400 E 2ND St
Defiance, OH 43512-2440

Mailing address

1400 E 2ND St
Defiance, OH 43512-2440
Phone (419) 784-1414

Other identifiers 1

IdentifierTypeStateIssuer
0878028MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101004000974 OH Practitioner - General Surgery 2365334182 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Toledo College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Medical Partners Northern Region Specialty Care LLCGroup PAC ID 9739585480, 86 clinicians

Practice addresses (Care Compare)

1600 E Riverview Ave
Napoleon, OH 43545-9399
Phone (419) 591-3832

27 St Lawrence Dr
Tiffin, OH 44883-8314
Phone (419) 455-8500

3900 Sunforest CT
Suite 240
Toledo, OH 43623-4481
Phone (419) 475-1600

45 St Lawrence Dr
Tiffin, OH 44883-8310
Phone (419) 455-8501

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy73
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux41
Melanoma (skin cancer) excision1-10
Removal of tissue15
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35062785POHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Partners Northern Region Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians North Specialty Care LLC Surgery CurrentSince Sep 1, 2021 Accepting new patients
Henry County Hospital Inc CurrentSince Mar 9, 2019 Accepting new patients
Mercy Health Physicians-North LLC CurrentSince Jan 1, 2019 Accepting new patients
Mercy Medical Partners Northern Region LLC CurrentSince Jan 1, 2012 Accepting new patients
Mercy Medical Partners Northern Region LLC CurrentSince Jan 1, 2012 Accepting new patients
Mercy Medical Partners Northern Region Specialty Care LLC Surgery CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians - North, LLC CurrentSince Jan 1, 2019 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Fauster Cameron Inc. Past Accepting new patients

Locations

1400 E 2nd St
Defiance, OH 43512
Phone (419) 784-1414

1600 E Riverview Ave
Napoleon, OH 43545
Phone (260) 344-3045

1600 E Riverview Ave
Ste 101
Napoleon, OH 43545
Phone (419) 592-8774

1600 E Riverview Ave
Ste 108
Napoleon, OH 43545

1035 W Wayne St
Paulding, OH 45879
Phone (419) 399-4080

27 St Lawrence Dr
Tiffin, OH 44883
Phone (419) 448-3486

2200 Jefferson Ave
Fl 5
Toledo, OH 43604
Phone (419) 251-9826

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

3900 Sunforest Ct
Ste 240
Toledo, OH 43623
Phone (419) 472-3126

Interoperability endpoints

  • Direct secure messaging: jpruitt81838@direct.bsmhealth.org

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300665600000",
    "number": "1689656696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E 2ND ST",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435122440",
            "telephone_number": "419-784-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E 2ND ST",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435122440",
            "telephone_number": "419-784-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "JEFFREY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2011-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35062785P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0878028",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Defiance, OH

Sources for this page

Verify at the official NPI Registry.