Individual provider Active NPI

Marc James Dinga, MD

  • Pulmonary Disease Physician
  • Mentor, OH
National Provider Identifier
1760470751
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
35043692 Issued in OH
Practice address
9500 Mentor Avemue
Suite 100
Mentor, OH 44060-8714
Phone
(440) 255-5620
Fax
(440) 375-8834
NPI assigned
Oct 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 35043692 OH
Pulmonary Disease Physician 207RP1001X 35043692 OH Primary

Addresses

Primary practice location

9500 Mentor Avemue
Suite 100
Mentor, OH 44060-8714

Mailing address

7590 Auburn Rd Ste 14
Concord TWP, OH 44077-9176
Phone (440) 354-1899

Other identifiers 2

IdentifierTypeStateIssuer
0534827MedicaidOH
H562870OtherOHMEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address marc.dinga@lhpg.eclinicaldirectplus.com Direct

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
I20080716000617 OH Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 7012993207 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35043692OHMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Hospital System, Inc CurrentSince May 31, 2017 Accepting new patients
Lake Hospital System Inc CurrentSince May 31, 2017 Accepting new patients
Lake Hospital System Inc Current Accepting new patients
Specialists in Pulmonary & Critical Care, Corp Critical Care Medicine Past Accepting new patients

Locations

7590 Auburn Rd
Ste 14
Concord Township, OH 44077
Phone (440) 354-1899

6270 N Ridge Rd
Madison, OH 44057
Phone (440) 428-8292

9500 Mentor Ave
Ste 100
Mentor, OH 44060
Phone (440) 352-4880

9500 Mentor Ave
Ste 300
Mentor, OH 44060
Phone (440) 269-8020

10780 Kinsman Rd
Newbury, OH 44065
Phone (440) 564-5656

4212 State Route 306
Ste 110
Willoughby, OH 44094
Phone (440) 953-9135

36000 Euclid Ave
Willoughby Hills, OH 44094
Phone (440) 375-8166

Organizations & group practices 4

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": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1760470751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7590 AUBURN RD STE 14",
            "city": "CONCORD TWP",
            "state": "OH",
            "postal_code": "440779176",
            "telephone_number": "440-354-1899",
            "fax_number": "440-354-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 MENTOR AVEMUE",
            "address_2": "SUITE 100",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440608714",
            "telephone_number": "440-255-5620",
            "fax_number": "440-375-8834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINGA",
        "first_name": "MARC",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OH",
            "license": "35043692",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OH",
            "license": "35043692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0534827",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "H562870",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marc.dinga@lhpg.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Baseline West Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "9500 Mentor Avemue",
            "address_2": "Suite 100",
            "city": "Mentor",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440608714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

Verify at the official NPI Registry.