NPIMap

Individual provider Active NPI

Anita Patibandla, MD

  • Obstetrics & Gynecology Physician
  • Oregon, OH
National Provider Identifier
1922293828
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
35.090715 Issued in OH
Practice address
2751 Bay Park Dr Ste 304
Oregon, OH 43616-4922
Phone
(194) 690-7580
Fax
(419) 697-7703
NPI assigned
Sep 13, 2007
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 35.090715 OH Primary

Addresses

Primary practice location

2751 Bay Park Dr Ste 304
Oregon, OH 43616-4922

Mailing address

1 Seagate Ste 800
Toledo, OH 43604-1558
Phone (419) 291-2192

Other identifiers 5

IdentifierTypeStateIssuer
05249OtherPARAMOUNT
000000544668OtherANTHEM
47358OtherHPM
9401079OtherAETNA
2794543MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address apatibandla14031@epicdirect.promedica.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080103000392 OH Practitioner - Obstetrics/Gynecology 9436239449 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay Park Community HospitalGroup PAC ID 1951200872, 18 clinicians

Practice addresses (Care Compare)

2801 Bay Park Dr
Oregon, OH 43616-4920
Phone (419) 690-7900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.090715OHMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians Obstetrics & Gynecology CurrentSince Sep 23, 2018 Accepting new patients
The Toledo Hospital CurrentSince Oct 1, 2007 Accepting new patients
Bay Park Community Hospital CurrentSince Dec 1, 2018 Accepting new patients
Promedica Central Physicians CurrentSince Sep 23, 2018 Accepting new patients
The Toledo Hospital CurrentSince Oct 1, 2007 Accepting new patients
Haematology-Oncology Associates of Ohio and Michigan PC Current Accepting new patients
Consultants in Laboratory Medicine of Greater Toledo Current Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Bay Park Community Hospital Past Accepting new patients

Locations

2751 Bay Park Dr
Ste 300
Oregon, OH 43616
Phone (419) 690-7596

2751 Bay Park Dr
Ste 304
Oregon, OH 43616
Phone (419) 690-7611

2801 Bay Park Dr
Oregon, OH 43616
Phone (419) 690-7652

5200 Harroun Rd
Sylvania, OH 43560
Phone (419) 824-1305

1 Seagate
Ste 800
Toledo, OH 43604

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: apatibandla14031@direct.promedica.org

Organizations & group practices 9

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 3

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": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1922293828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SEAGATE STE 800",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041558",
            "telephone_number": "419-291-2192",
            "fax_number": "419-479-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 BAY PARK DR STE 304",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436164922",
            "telephone_number": "194-690-7580",
            "fax_number": "419-697-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATIBANDLA",
        "first_name": "ANITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-13",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "35.090715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT",
            "identifier": "05249",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000544668",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPM",
            "identifier": "47358",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9401079",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2794543",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apatibandla14031@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oregon, OH

Sources for this page

Verify at the official NPI Registry.