Individual provider Active NPI

Daniel Earl Detrich, M.D.

  • Surgery Physician
  • Mansfield, OH
National Provider Identifier
1780661793
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35054441 Issued in OH
Practice address
215 Wood St
Mansfield, OH 44903-2260
Phone
(419) 522-2833
Fax
(419) 524-1619
NPI assigned
Dec 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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 35054441 OH Primary

Addresses

Primary practice location

215 Wood St
Mansfield, OH 44903-2260

Mailing address

215 Wood St
Ohiohealth Surgical Specialists
Mansfield, OH 44903-2260
Phone (419) 552-2833

Other identifiers 3

IdentifierTypeStateIssuer
000000130383OtherOHANTHEM
020011318OtherOHRAILROAD MEDICARE
0789080MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ddetrich112695@direct.ohiohealth.com OhioHealth Physician Group

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
I20100419000122 OH Practitioner - General Surgery 4587608104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Cincinnati College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

199 W Main St
Shelby, OH 44875-1490

335 Glessner Ave
Mansfield, OH 44903-2269

393 E Town St
Columbus, OH 43215-4799

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy101
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux59
Melanoma (skin cancer) excision20
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35054441OHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation Current Accepting new patients
Ohiohealth Corporation CurrentSince Jul 15, 2014 Accepting new patients
Ohiohealth Corporation CurrentSince Jul 15, 2014 Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

5350 Frantz Rd
Dublin, OH 43016

335 Glessner Ave
Mansfield, OH 44903
Phone (419) 522-0320

335 Glessner Ave
Fl 5
Mansfield, OH 44903
Phone (419) 522-2833

215 Wood St
Mansfield, OH 44903
Phone (419) 522-2833

199 W Main St
Shelby, OH 44875
Phone (419) 342-5015

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1780661793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 WOOD ST",
            "address_2": "OHIOHEALTH SURGICAL SPECIALISTS",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449032260",
            "telephone_number": "419-552-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 WOOD ST",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449032260",
            "telephone_number": "419-522-2833",
            "fax_number": "419-524-1619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETRICH",
        "first_name": "DANIEL",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35054441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000130383",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020011318",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0789080",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ddetrich112695@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "335 Glessner Ave",
            "address_2": "MOB 5th Fl",
            "city": "Mansfield",
            "state": "OH",
            "country_code": "US",
            "postal_code": "449032269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

Verify at the official NPI Registry.