Robert W Secor, MD
Individual provider Active NPI Family Medicine Physician · Sycamore, OH
NPI 1861494478 · NPPES record last updated Dec 15, 2020
Key facts
- NPI
- 1861494478
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 35.057598 (OH)
- Practice address
- 103 N Pennington St
Sycamore, OH 44882-9408 - Phone
- (419) 927-6552
- Fax
- (419) 933-4502
- NPI assigned
- Aug 12, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 16
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Wright State University Boonshoft School of Medicine, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Wyandot Memorial Hospital
Practice addresses (Care Compare)
412 W Saffell Ave
Sycamore, OH 44882-9763
Phone (419) 927-6552
Hospital & facility affiliations
- Med1Care, LLC
- Wyandot Memorial Hospital
- Mercy Health - Tiffin Hospital
- Mercy Health - Willard Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100625000000 | OH | Practitioner - Family Practice | 5294870077 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.057598 | OH | MD | Family Medicine Physician |
| 35057598 | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wyandot Memorial Hospital | Current |
Accepting new patients | |
| Galion Community Hospital | Family Medicine | Current |
Accepting new patients |
| Wyandot Memorial Hospital | Current |
Accepting new patients | |
| Galion Community Hospital | Current |
Accepting new patients | |
| Willard Medical Center, Inc. | Current | Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients | |
| City of Blossoms Inpatient Services LLC | Past |
Accepting new patients | |
| Wyandot Memorial Hospital | Family Medicine | Past | Accepting new patients |
Locations
269 Portland Way S
Galion, OH 44833
Phone (419) 468-4841
2981 W 4th St
Ontario, OH 44906
Phone (419) 468-0505
412 W Saffell Ave
Sycamore, OH 44882
Phone (419) 927-6552
885 N Sandusky Ave
Upper Sandusky, OH 43351
Phone (419) 294-4991
218 S Myrtle Ave
Willard, OH 44890
Phone (419) 933-2811
Interoperability endpoints
- rsecor805622@direct.bsmhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35057598 | OH | |
| Family Medicine Physician | 207Q00000X | 35.057598 | OH | Yes |
Addresses
Primary practice location
103 N Pennington St
Sycamore, OH 44882-9408
Mailing address
885 N Sandusky Ave
Upper Sandusky, OH 43351-1098
Phone (419) 294-4991
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0799300 | Medicaid | OH | |
| 700006733 | Other | OH | RR MEDICARE |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rsecor805622@direct.mercy.com |
Other providers in Sycamore, OH
- Sydney Elizabeth Lommerse
- Mohawk Fire and Rescue District
- Mohawk Local School District
- Kevin Pelter
- Bridgett Rivera
- Lori Swecker
- Seth Swecker
- Sycamore Medical Associates, Inc.
- Sycamore Village Office of Clerk
- Wyandot Memorial Hospital
All providers in Sycamore, OH · Family Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.