Individual provider Active NPI

Martin Akusoba, M.D.

  • Emergency Medicine Physician
  • Upper Sandusky, OH
National Provider Identifier
1811928302
Registry record updated Apr 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
67202 Issued in OH
Practice address
885 N Sandusky Ave
Upper Sandusky, OH 43351-1031
Phone
(419) 294-4991
NPI assigned
Jul 5, 2006
Last updated
Apr 8, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 67202 OH Primary
Emergency Medicine Physician 207P00000X 192994 NY

Addresses

Primary practice location

885 N Sandusky Ave
Upper Sandusky, OH 43351-1031

Mailing address

3378 Wheel Wright Dr
Galena, OH 43021-9748
Phone (740) 965-4893

Other identifiers 2

IdentifierTypeStateIssuer
0974218MedicaidOH
1811928302MedicaidOH

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
I20040830000310 OH Practitioner - Internal Medicine 5496720856 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allen Emergency Physicians LLCGroup PAC ID 9739554379, 13 clinicians

Practice addresses (Care Compare)

200 W Lorain St
Oberlin, OH 44074-1026
Phone (440) 775-1211

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.54 of 100Reported as group
Quality
81.55
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
86.62 of 100Reported as group
Quality
71.63
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
192994NYMDEmergency Medicine Physician
67202OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lorain Emergency Physicians, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Williams Emergency Group, LLC Emergency Medicine CurrentSince May 1, 2019 Accepting new patients
Crestline Medical Center, Inc CurrentSince Mar 11, 2008 Accepting new patients
Allen Emergency Physicians, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
River Valley Physicians, LLC CurrentSince Oct 17, 2024 Accepting new patients
Crestline Medical Center LLC PastSince Aug 16, 2012 Accepting new patients
Medcentral Professional Foundation, LLC PastSince Apr 1, 2008 Accepting new patients
Ohio Emergency Professionals Inc Emergency Medicine Past Accepting new patients

Locations

433 W High St
Bryan, OH 43506
Phone (419) 636-1131

1460 Orange St
Coshocton, OH 43812
Phone (740) 545-7919

15655 State Route 170
Ste B
East Liverpool, OH 43920
Phone (330) 386-3610

15655 State Route 170
Ste H
East Liverpool, OH 43920
Phone (330) 932-0183

425 W 5th St
East Liverpool, OH 43920
Phone (330) 385-7200

3700 Kolbe Rd
Lorain, OH 44053
Phone (440) 331-9520

909 E Snyder Ave
Montpelier, OH 43543
Phone (419) 485-3154

200 W Lorain St
Oberlin, OH 44074
Phone (440) 775-1211

720 Worthington Woods Blvd
Worthington, OH 43085
Phone (614) 785-4700

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FBJFBA

Organizations & group practices 8

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 2

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270684800000",
    "number": "1811928302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3378 WHEEL WRIGHT DR",
            "city": "GALENA",
            "state": "OH",
            "postal_code": "430219748",
            "telephone_number": "740-965-4893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 N SANDUSKY AVE",
            "city": "UPPER SANDUSKY",
            "state": "OH",
            "postal_code": "433511031",
            "telephone_number": "419-294-4991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKUSOBA",
        "first_name": "MARTIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2010-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "67202",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "192994",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0974218",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811928302",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Sandusky, OH

Sources for this page

Verify at the official NPI Registry.