NPIMap

Individual provider Active NPI

Mohan Dutt, M.D.

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Sylvania, OH
National Provider Identifier
1912320425
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084S0012X
License
35C.001162 Issued in OH
Practice address
5308 Harroun Rd Ste 180
Sylvania, OH 43560-2190
Phone
(419) 291-7555
Fax
(419) 479-2696
NPI assigned
Feb 4, 2014
Last updated
Jan 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 4301114307 MI
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 35C.001162 OH Primary
Internal Medicine Physician 207R00000X 4301114307 MI

Addresses

Primary practice location

5308 Harroun Rd Ste 180
Sylvania, OH 43560-2190

Mailing address

100 Madison Ave
Toledo, OH 43604-1516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180713001397 MI Practitioner - Neurology 7719243633 Reassigns benefits to 2 organizations
I20240110004633 OH Practitioner - Sleep Medicine 7719243633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sleep Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Promedica Multi Specialty PhysiciansGroup PAC ID 7113182809, 269 clinicians

Practice addresses (Care Compare)

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-1111

718 N Macomb St
Monroe, MI 48162-7815
Phone (419) 240-8835

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35C.001162OHMDSleep Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Multi Specialty Physicians CurrentSince Jan 28, 2025 Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

777 Kimole Ln
Ste 130
Adrian, MI 49221
Phone (517) 265-0292

777 Kimole Ln
Ste 250
Adrian, MI 49221
Phone (517) 265-3411

718 N Macomb St
Monroe, MI 48162
Phone (734) 212-3097

730 N Macomb St
Ste 300
Monroe, MI 48162
Phone (734) 235-5296

5308 Harroun Rd
Ste 180
Sylvania, OH 43560
Phone (419) 824-5207

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

Interoperability endpoints

  • Direct secure messaging: mdutt304313@direct.promedica.org

Organizations & group practices 3

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.

Hospital & facility affiliations 7

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": "1391472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1912320425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MADISON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5308 HARROUN RD STE 180",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602190",
            "telephone_number": "419-291-7555",
            "fax_number": "419-479-2696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTT",
        "first_name": "MOHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-04",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "MI",
            "license": "4301114307",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "OH",
            "license": "35C.001162",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301114307",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.