Individual provider Active NPI

Michael Todd Retholtz, D.O.

  • Hospitalist Physician
  • Maumee, OH
National Provider Identifier
1912941246
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
34008582 Issued in OH
Practice address
5901 Monclova Rd
Maumee, OH 43537-1841
Phone
(419) 887-6754
NPI assigned
Jun 16, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34-008582 OH
Hospitalist Physician 208M00000X 34008582 OH Primary

Addresses

Primary practice location

5901 Monclova Rd
Maumee, OH 43537-1841

Mailing address

4235 Secor Rd
Toledo, OH 43623-4231
Phone (419) 479-5327

Other identifiers 1

IdentifierTypeStateIssuer
2639050MedicaidOH

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060331000588 OH Practitioner - HospitalistPractitioner - Internal Medicine 9931117967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Ohio University, College of Osteopathic Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2213 Cherry St
Toledo, OH 43608-2603
Phone (419) 251-8019

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34-008582OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Mar 14, 2022 Accepting new patients
Mercy Health Physicians North Specialty Care LLC Hospitalist CurrentSince Mar 14, 2022 Accepting new patients
Mercy Health - St Vincent Medical Center LLC Past Accepting new patients

Locations

1103 Village Square Dr
Ste 100
Perrysburg, OH 43551
Phone (419) 872-3213

2213 Cherry St
Toledo, OH 43608
Phone (419) 251-4283

2213 Cherry St
Ste 200
Toledo, OH 43608
Phone (419) 251-4283

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

3900 Sunforest Ct
Ste 240
Toledo, OH 43623
Phone (419) 472-3126

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 2

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1912941246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234231",
            "telephone_number": "419-479-5327",
            "fax_number": "419-479-5593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 MONCLOVA RD",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371841",
            "telephone_number": "419-887-6754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETHOLTZ",
        "first_name": "MICHAEL",
        "middle_name": "TODD",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34-008582",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "34008582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2639050",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

Verify at the official NPI Registry.