Amar Basavaraj Mutnal, M.D.

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

35.120264 Issued in OH

Practice address

5319 Hoag Dr Ste 240
Sheffield Village, OH 44035-1493

Phone

(419) 626-6161

Fax

(419) 502-3537

NPI assigned

May 10, 2007

Last updated

Jan 28, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

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

Specialty

Orthopedic SurgeryAlso: Sports Medicine

Education

University of Michigan Medical School, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northern Ohio Medical Specialists,LLCGroup PAC ID 2769386192, 252 clinicians

Union Physician Services LLCGroup PAC ID 0143366591, 97 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Union Hospital Hospital, Dover, OH, CCN 360010
• Euclid Hospital Hospital, Euclid, OH, CCN 360082
• Cleveland Clinic Hospital, Cleveland, OH, CCN 360180

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amutnal20568@nomshealthcare.direct-ci.com

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.

• Northern Ohio Medical Specialists LLC

  • Internal Medicine Physician
  • Sandusky, OH
  • NPI 1225085855

  Orthopaedic Surgery

  Medicare reassignment Care Compare group NPD
• Union Physician Services, LLC

  • Family Medicine Physician
  • Dover, OH
  • NPI 1215169826

  Orthopaedic Surgery

  Medicare reassignment Care Compare group NPD
• Ashtabula County Medical Center

  dba The Ashtabula Clinic

  • Specialist
  • Ashtabula, OH
  • NPI 1942247143
  Medicare reassignment NPD
• Northern Ohio Medical Specialists, LLC

  dba NOMS Healthcare

  • Durable Medical Equipment & Medical Supplies
  • Lorain, OH
  • NPI 1952281511
  NPD
• Northern Ohio Medical Specialists, LLC

  dba NOMS Premium Imaging Center

  • Radiology Clinic/Center
  • Sheffield Village, OH
  • NPI 1508811332
  NPD (past)

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

• Cleveland Clinic Health System - East Region

  dba Euclid Hospital

  • General Acute Care Hospital
  • Euclid, OH
  • NPI 1598719346
  Care Compare affiliation
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Care Compare affiliation
• The Union Hospital Association

  dba Union Hospital

  • Rural Acute Care Hospital
  • Dover, OH
  • NPI 1871606921
  Care Compare affiliation

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1790999415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 378",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448710378",
            "telephone_number": "419-609-1112",
            "fax_number": "419-502-3537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5319 HOAG DR STE 240",
            "city": "SHEFFIELD VILLAGE",
            "state": "OH",
            "postal_code": "440351493",
            "telephone_number": "419-626-6161",
            "fax_number": "419-502-3537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTNAL",
        "first_name": "AMAR",
        "middle_name": "BASAVARAJ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "35.120264",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "OH",
            "license": "35.120264",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "FL",
            "license": "ME108709",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "OH",
            "license": "35.120264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi A Morris, D.O.
• Brian Moser
• Digna Moya, MD
• Rummel T Moya, MD
• Mary Munn, LISW
• Arthur J Myers, PA-C
• Neurospinecare, Inc.
• Kimberly Marie Nichelson, DPM
• Brittney M Nighswander, PT
• Sasha Natalie Noe, DO, PHD

• Sports Medicine (Orthopaedic Surgery) Physician in Sheffield Village, OH
• Providers in Sheffield Village, OH by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.