Active NPI
Terry E Pietryga, M.D.
- Diagnostic Radiology Physician
- Toledo, OH
National Provider Identifier
1972571099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 35.085668
- Practice address
- 2213 Cherry St
Toledo, OH 43608-2603 - Phone
- (419) 251-3232
- NPI assigned
- Mar 14, 2006
- Last updated
- Oct 9, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 35.085668 | OH | Primary |
| Diagnostic Radiology Physician | 2085R0202X | 435570 | PA | |
| Diagnostic Radiology Physician | 2085R0202X | 4301072096 | MI | |
| Diagnostic Radiology Physician | 2085R0202X | 01060109A | IN |
Addresses
Primary practice location
2213 Cherry St
Toledo, OH 43608-2603
Mailing address
3570 Sunningdale Dr N
Saginaw, MI 48604-9772
Phone (810) 252-2194
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4692907 | Medicaid | MI | |
| 4692952 | Medicaid | MI | |
| 4692961 | Medicaid | MI | |
| 2535411 | Medicaid | OH | |
| P00191476 | Other | OH | RAILROAD MEDICARE |
| 000000354582 | Other | OH | ANTHEM BCBS |
| 4692916 | Medicaid | MI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 01060109A | IN | MD | Diagnostic Radiology Physician |
| 35.085668 | OH | MD | Diagnostic Radiology Physician |
| 435570 | PA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fountain City Medical Clinic Inc | Past | Accepting new patients | |
| Radadvantage a Professional Corporation | Diagnostic Radiology | Past | Accepting new patients |
| Pro Rad, Inc | Diagnostic Radiology | Past | Accepting new patients |
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.
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- Diagnostic Radiology Physician
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- NPI 1962470484
-
- Diagnostic Radiology Physician
- Phoenix, AZ
- NPI 1376719666
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381276800000",
"number": "1972571099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3570 SUNNINGDALE DR N",
"city": "SAGINAW",
"state": "MI",
"postal_code": "486049772",
"telephone_number": "810-252-2194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2213 CHERRY ST",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436082603",
"telephone_number": "419-251-3232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIETRYGA",
"first_name": "TERRY",
"middle_name": "E",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-14",
"last_updated": "2013-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "OH",
"license": "35.085668",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "PA",
"license": "435570",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MI",
"license": "4301072096",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IN",
"license": "01060109A",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4692907",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4692952",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4692961",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2535411",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00191476",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000354582",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4692916",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.