Individual provider Active NPI

Bryce Niewoehner, PA

  • Physician Assistant
  • Marion, OH
National Provider Identifier
1841034907
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.008777RX Issued in OH
Practice address
1051 Harding Memorial Pkwy Ste B
Marion, OH 43302-6347
Phone
(740) 383-5115
Fax
(740) 387-3668
NPI assigned
Jun 24, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 50.008777RX OH Primary

Addresses

Primary practice location

1051 Harding Memorial Pkwy Ste B
Marion, OH 43302-6347

Mailing address

1051 Harding Memorial Pkwy Ste B
Marion, OH 43302-6347
Phone (740) 383-5115

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240729000618 OH Practitioner - Physician Assistant 4789120593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ankle and Foot Specialists of Marion IncGroup PAC ID 9335204924, 4 clinicians

Practice addresses (Care Compare)

1051 Harding Memorial Pkwy
Suite B
Marion, OH 43302-6347
Phone (740) 383-5115

Hospital & facility affiliations

  • Marion General Hospital Hospital, Marion, OH, CCN 360011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Marion Independent Physicians Association, LLC Single Specialty 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.

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": "1719187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1841034907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 HARDING MEMORIAL PKWY STE B",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026347",
            "telephone_number": "740-383-5115",
            "fax_number": "740-387-3668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 HARDING MEMORIAL PKWY STE B",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026347",
            "telephone_number": "740-383-5115",
            "fax_number": "740-387-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEWOEHNER",
        "first_name": "BRYCE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-24",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.008777RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, OH

Sources for this page

Verify at the official NPI Registry.