Individual provider Active NPI

Zubin Mistry, PH.D.

  • Clinical Psychologist
  • Toledo, OH
National Provider Identifier
1841338613
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5423 Issued in OH
Practice address
3536 Glendale Ave
Toledo, OH 43614-3454
Phone
(419) 380-0400
Fax
(419) 380-9106
NPI assigned
Feb 2, 2007
Last updated
Apr 20, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 5423 OH Primary

Addresses

Primary practice location

3536 Glendale Ave
Toledo, OH 43614-3454

Mailing address

3536 Glendale Ave
Toledo, OH 43614-3454
Phone (419) 380-0400

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051117000018 OH Practitioner - Clinical Psychologist 0345269684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3536 Glendale Ave
Toledo, OH 43614-3454
Phone (419) 380-0400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5423OHMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Zubin J. Mistry & Associates Clinical CurrentSince Jul 1, 1998 Accepting new patients
Elliott & Associates Inc PastSince Jan 30, 2011 Accepting new patients

Locations

3536 Glendale Ave
Toledo, OH 43614
Phone (419) 380-0400

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

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1841338613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3536 GLENDALE AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436143454",
            "telephone_number": "419-380-0400",
            "fax_number": "419-380-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3536 GLENDALE AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436143454",
            "telephone_number": "419-380-0400",
            "fax_number": "419-380-9106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISTRY",
        "first_name": "ZUBIN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "5423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.