Individual provider Active NPI

Michael Allen Neiswander, MD

  • Family Medicine Physician
  • Perrysburg, OH
National Provider Identifier
1932170040
Registry record updated Feb 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-074350 Issued in OH
Practice address
702 Commerce Dr
Suite 160
Perrysburg, OH 43551-5239
Phone
(419) 872-7600
Fax
(419) 872-7601
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2013

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 35-074350 OH Primary

Addresses

Primary practice location

702 Commerce Dr
Suite 160
Perrysburg, OH 43551-5239

Mailing address

702 Commerce Dr
Suite 160
Perrysburg, OH 43551-5239
Phone (419) 872-7600

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
I20041019000008 OH Practitioner - Family Practice 3072573500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-074350OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients
Medical Emergency Treatment Corporation Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360886400000",
    "number": "1932170040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 COMMERCE DR",
            "address_2": "SUITE 160",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435515239",
            "telephone_number": "419-872-7600",
            "fax_number": "419-872-7601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 COMMERCE DR",
            "address_2": "SUITE 160",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435515239",
            "telephone_number": "419-872-7600",
            "fax_number": "419-872-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEISWANDER",
        "first_name": "MICHAEL",
        "middle_name": "ALLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2013-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-074350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

Verify at the official NPI Registry.