Individual provider Active NPI

Pratik M Vaishnav, M.D.

  • Emergency Medicine Physician
  • Marietta, OH
National Provider Identifier
1982655833
Registry record updated Nov 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35087579 Issued in OH
Practice address
401 Matthew St
Emergency Department
Marietta, OH 45750-1635
Phone
(740) 376-1939
Fax
(740) 374-1693
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35087579 OH Primary

Addresses

Primary practice location

401 Matthew St
Emergency Department
Marietta, OH 45750-1635

Mailing address

PO Box 449
Marietta, OH 45750-0449
Phone (740) 374-4500

Other identifiers 3

IdentifierTypeStateIssuer
P01036918OtherOHRAILROAD MEDICARE PTAN
2653203MedicaidOH
3810005301MedicaidWV

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
I20060615000181 OH Practitioner - Family PracticePractitioner - Emergency Medicine 8224040175 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35087579OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hles of Ohio, Inc. Emergency Medicine Current Accepting new patients
Hles of Ohio Inc Emergency Medicine CurrentSince Feb 13, 2017 Accepting new patients
River Valley Physicians, LLC CurrentSince Nov 1, 2024 Accepting new patients
Hles of Ohio Inc Emergency Medicine CurrentSince Feb 13, 2017 Accepting new patients
Openloop Healthcare Partners PC Past Accepting new patients

Locations

1460 Orange St
Coshocton, OH 43812
Phone (740) 545-7919

15655 State Route 170
Ste H
East Liverpool, OH 43920
Phone (330) 932-0183

15655 State Route 170
Ste B
East Liverpool, OH 43920
Phone (330) 386-3610

425 W 5th St
East Liverpool, OH 43920
Phone (330) 385-7200

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FBJFBA

Organizations & group practices 5

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352332800000",
    "number": "1982655833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 449",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457500449",
            "telephone_number": "740-374-4500",
            "fax_number": "740-374-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MATTHEW ST",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457501635",
            "telephone_number": "740-376-1939",
            "fax_number": "740-374-1693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAISHNAV",
        "first_name": "PRATIK",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2012-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35087579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P01036918",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2653203",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810005301",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, OH

Sources for this page

Verify at the official NPI Registry.