Individual provider Active NPI

Philip R. Masser, M.D.

  • Family Medicine Physician
  • Celina, OH
National Provider Identifier
1891793618
Registry record updated May 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35049039 Issued in OH
Practice address
801 Pro Dr
Suite a
Celina, OH 45822-3307
Phone
(419) 586-3113
Fax
(419) 586-6560
NPI assigned
Jul 14, 2005
Last updated
May 17, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35049039 OH Primary

Addresses

Primary practice location

801 Pro Dr
Suite a
Celina, OH 45822-3307

Mailing address

801 Pro Dr
Suite a
Celina, OH 45822-3307
Phone (419) 586-3113

Other identifiers 1

IdentifierTypeStateIssuer
0535353MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35049039OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Celina Family Practice Family Medicine CurrentSince May 26, 1970 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

724 E Wayne St
Celina, OH 45822
Phone (419) 586-2216

801 Pro Dr
Ste A
Celina, OH 45822
Phone (419) 586-3113

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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305590400000",
    "number": "1891793618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 PRO DR",
            "address_2": "SUITE A",
            "city": "CELINA",
            "state": "OH",
            "postal_code": "458223307",
            "telephone_number": "419-586-3113",
            "fax_number": "419-586-6560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 PRO DR",
            "address_2": "SUITE A",
            "city": "CELINA",
            "state": "OH",
            "postal_code": "458223307",
            "telephone_number": "419-586-3113",
            "fax_number": "419-586-6560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSER",
        "first_name": "PHILIP",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2011-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35049039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0535353",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Celina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.