John M Mauric, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

34-004778 Issued in OH

Practice address

605 3Rd Ave
Suite D
Fremont, OH 43420-3269

Phone

(419) 355-8070

Fax

(419) 355-1109

NPI assigned

Jun 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Family Practice

Education

Ohio University, College of Osteopathic Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Provider Health Utah PLLCGroup PAC ID 0042649113, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ogden Regional Medical Center Hospital, Ogden, UT, CCN 460005
• Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Premier Provider Health Utah PLLC

  • Internal Medicine Physician
  • Ogden, UT
  • NPI 1699311209

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Health West, Inc.

  • Federally Qualified Health Center (FQHC)
  • Providence, UT
  • NPI 1528774452
  Medicare reassignment NPD
• Health West, Inc.

  • Federally Qualified Health Center (FQHC)
  • Garden City, UT
  • NPI 1013623941

  Family Medicine

  NPD
• Health West, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pocatello, ID
  • NPI 1740143882
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Columbia Ogden Medical Center, Inc.

  • General Acute Care Hospital
  • Ogden, UT
  • NPI 1720031636
  Care Compare affiliation
• Ihc Health Services Inc

  • General Acute Care Hospital
  • Ogden, UT
  • NPI 1194749580
  Care Compare affiliation

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451520000000",
    "number": "1891731659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 3RD AVE",
            "address_2": "SUITE D",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434203269",
            "telephone_number": "419-355-8070",
            "fax_number": "419-355-1109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 3RD AVE",
            "address_2": "SUITE D",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434203269",
            "telephone_number": "419-355-8070",
            "fax_number": "419-355-1109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURIC",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2015-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34-004778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080172711",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0827627",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM B/C B/S",
            "identifier": "000000201363",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEYE MEDICAID",
            "identifier": "740142",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUMMACARE",
            "identifier": "R04778",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Wonderly MD LLC
• Inge Marion Massie
• Margaret A Mathews, PT
• Mark A. Mathews, O.D.
• Clarissa Matthews, PCC, LPCC, LSW
• Casey Thomas McConihe
• Andrew Michael McCormick
• Trina McKown
• Michael Scott Mead Sr., DDS
• Thomas Wesley Meade, O.D.

• Family Medicine Physician in Fremont, OH
• Providers in Fremont, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.