Individual provider Active NPI

Todd J Hixenbaugh, MD

  • Surgery Physician
  • Lima, OH
National Provider Identifier
1730136839
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35050679H Issued in OH
Practice address
658 W Market St Ste 201
Lima, OH 45801-5609
Phone
(419) 303-6528
NPI assigned
May 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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 35050679H OH Primary

Addresses

Primary practice location

658 W Market St Ste 201
Lima, OH 45801-5609

Mailing address

2790 Shagbark Dr
Lima, OH 45806-1636

Other identifiers 1

IdentifierTypeStateIssuer
0565795MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20100304000982 OH Practitioner - General Surgery 1759426497 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35050679HOHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Todd J Hixenbaugh MD LLC Surgery CurrentSince Jan 1, 2023 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Mercy Health-St Ritas Medical Center LLC Past Accepting new patients

Locations

658 W Market St
Ste 201
Lima, OH 45801
Phone (419) 879-6528

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1730136839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 SHAGBARK DR",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458061636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 W MARKET ST STE 201",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458015609",
            "telephone_number": "419-303-6528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIXENBAUGH",
        "first_name": "TODD",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35050679H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0565795",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.