Organization Active NPI

Wissam Hoteit MD LLC

  • Psychiatry Physician
  • Sylvania, OH
National Provider Identifier
1710456025
Registry record updated Nov 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
WISSAM HOTEIT MD LLC
Practice address
4841 Yosemite Pkwy
Sylvania, OH 43560-4341
Phone
(419) 885-0200
NPI assigned
Nov 15, 2018
Last updated
Nov 15, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2018

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

Authorized official

Name
Wissam Hoteit, MDNPI 1265673990
Title
Owner
Phone
(419) 885-0200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X Primary

Addresses

Primary practice location

4841 Yosemite Pkwy
Sylvania, OH 43560-4341

Mailing address

PO Box 8440
Toledo, OH 43623-0440
Phone (419) 885-0200

Other identifiers 1

IdentifierTypeStateIssuer
0070488MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190110001036 OH Part B Supplier - Clinic/Group Practice 4587900667 Receives reassigned benefits from 1 practitioner
Practice locations: Sylvania, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542240000000",
    "number": "1710456025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8440",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436230440",
            "telephone_number": "419-885-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4841 YOSEMITE PKWY",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435604341",
            "telephone_number": "419-885-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISSAM HOTEIT MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-15",
        "last_updated": "2018-11-15",
        "status": "A",
        "authorized_official_last_name": "HOTEIT",
        "authorized_official_first_name": "WISSAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-885-0200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0070488",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.