Individual provider Active NPI

Michael A Trygstad, DO

  • Family Medicine Physician
  • Jackson Center, OH
National Provider Identifier
1801847173
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34-008129 Issued in OH
Practice address
602 W Pike St
Jackson Center, OH 45334-9727
Phone
(937) 596-6123
Fax
(937) 596-6057
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34-008129 OH Primary

Addresses

Primary practice location

602 W Pike St
Jackson Center, OH 45334-9727

Mailing address

915 West Michigan St
Sidney, OH 45365-2401
Phone (937) 596-6123

Other identifiers 1

IdentifierTypeStateIssuer
2445269MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address michael.trygstad@wilsonhospital.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34-008129OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grays Harbor County Public Hospital District No. 1 Family Medicine Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Organizations & group practices 2

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1801847173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 WEST MICHIGAN ST",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453652401",
            "telephone_number": "937-596-6123",
            "fax_number": "937-596-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 W PIKE ST",
            "city": "JACKSON CENTER",
            "state": "OH",
            "postal_code": "453349727",
            "telephone_number": "937-596-6123",
            "fax_number": "937-596-6057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRYGSTAD",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34-008129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2445269",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.trygstad@wilsonhospital.medicity.net",
            "affiliation": "N",
            "address_1": "602 W Pike St",
            "city": "Jackson Center",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453349727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson Center, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.