OHIO PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC (NPI# 1508264680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508264680 |
| Entity Type | Organization |
| Organization Name | OHIO PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC |
| Practice Address |
5757 Monclova Rd Suite 5 Maumee OH 43537-1863 |
| Practice Telephone | 4198935757 |
| Practice Fax Number | 4198935399 |
| Mailing Telephone | 4198935757 |
| Mailing Fax Number | 4198935399 |
| Enumeration Date | 2014-12-05 |
| Last Update Date | 2014-12-05 |
| Authorized Official Name | BEAU GREGORY BORTEL (PHYSICIAN) |
| Authorized Official Telephone | 4198935757 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
36003428 | OH | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
36003428 | OH | Podiatric Medicine & Surgery Service Providers |
| Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
36003428 | OH | Podiatric Medicine & Surgery Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043617020 | Ohio Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 5925 N. Main St., Suite D, Dayton, OH 45415-3142 | 2014-11-19 |
| 1497152474 | Ohio Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 2207 Olympic Ave., Springfield, OH 45503-2725 | 2014-11-19 |
| 1093111080 | Ohio Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 1911 N. Fairfiled Rd, Suite 210, Beavercreek, OH 45432-2754 | 2014-11-18 |
| 1003204967 | Ohio Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 7529 State Rd, Suite B, Cincinnati, OH 45255-6409 | 2014-12-30 |
| 1265830566 | Ohio Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 1275 Olentangy River Rd, Suite 120, Columbus, OH 43212-3119 | 2014-12-18 |
| 1134526395 | Ohio Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 26151 Euclid Ave, Euclid, OH 44132-3322 | 2014-12-03 |
| 1699172908 | Ohio Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 3 Greenville Orthopedic Ctr, Greenville, PA 16125-1210 | 2014-12-02 |
| 1295132793 | Ohio Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 3731 Pearl Rd, Cleveland, OH 44109-2750 | 2014-11-26 |
| 1710384516 | Ohio Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 4041 N High St, Ste. 101, Columbus, OH 43214-3247 | 2014-11-24 |
| 1194122903 | Ohio Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 1265 Boardman Canfield Rd, Youngstown, OH 44512-4004 | 2014-11-21 |
| Street Address |
5757 MONCLOVA RD SUITE 5 |
| City | MAUMEE |
| State | OH |
| Zip Code | 43537-1863 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891790804 | Gary F Gladieux | Specialist | 5757 Monclova Rd, Suite 10, Maumee, OH 43537-1863 | 2005-06-16 |
| 1134641129 | Renella Alcaraz Gauamis | Family Medicine | 5757 Monclova Rd, Maumee, OH 43537-1863 | 2017-07-11 |
| 1295182640 | Kristine Louise Brogan | Nurse Practitioner | 5757 Monclova Rd, Maumee, OH 43537 | 2016-05-16 |
| 1023492709 | Megan Palmer | Nurse Practitioner | 5757 Monclova Rd, Suite 10, Maumee, OH 43537-1863 | 2015-07-13 |
| 1184051468 | Promedica Genito-urinary Surgeons LLC | Urology | 5757 Monclova Rd, Suite 6, Maumee, OH 43537-1863 | 2013-10-02 |
| 1265870935 | Ankita Singh | Family Medicine | 5757 Monclova Rd, # 15, Maumee, OH 43537-1863 | 2013-06-04 |
| 1144575226 | Nancy Keeton | Nurse Practitioner | 5757 Monclova Rd, Suite15, Maumee, OH 43537-1863 | 2012-07-16 |
| 1902180987 | Christina Ashley Hammerling | Physician Assistant | 5757 Monclova Rd, # 15, Maumee, OH 43537-1863 | 2011-10-07 |
| 1942499504 | Arrowhead Podiatry Associates Inc. | Podiatrist | 5757 Monclova Rd, Suite 5, Maumee, OH 43537-1863 | 2007-10-19 |
| 1982804225 | Richard Krasula | Physical Therapy Assistant | 5757 Monclova Rd, Suite 18, Maumee, OH 43537-1863 | 2007-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245884709 | Mary Walasinski | Behavior Technician | 1900 Indian Wood Circle Suite 100, Maumee, OH 43537 | 2019-08-01 |
| 1912483314 | Integrated Restorative Solutions LLC | Pain Medicine | 2718 River Rd, Maumee, OH 43537 | 2018-07-18 |
| 1326533373 | Michelle Lei Sandwisch | Nurse Practitioner | 7140 Maumee Western Road, Maumee, OH 43537 | 2018-06-22 |
| 1669978201 | Bradley D Walker | Case Manager/Care Coordinator | 1600 Michigan Ave, Maumee, OH 43537 | 2018-04-03 |
| 1841792306 | Stephen Flory | Specialist/Technologist | 2584 S Detroit Ave, Maumee, OH 43537 | 2018-03-01 |
| 1851841787 | Michelle Laver | Social Worker | 7320 Sh 108, Wauseon, OH 43537 | 2016-10-04 |
| 1083070288 | Friends Who Care | Home Health | 2749 Pine Trace Dr, Maumee, OH 43537 | 2016-01-05 |
| 1386025203 | Unique Health Care Solutions, LLC | Home Health | 3430 Briarfield Blvd, Maumee, OH 43537 | 2015-06-16 |
| 1104239698 | Jill Saul | Dietitian, Registered | 5871 Monclova Rd., Maumee, OH 43537 | 2014-06-03 |
| 1922438910 | Kristen Junga | Counselor | 1627 Henthorne Dr Ste E, Maumee, OH 43537 | 2013-11-12 |
| Find all providers in zip 43537 | ||||
| Taxonomy Code | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023361318 | Lara S Poduska Dpm LLC | Podiatrist | 24816 Aurora Rd Ste A, Bedford Heights, OH 44146-6908 | 2012-10-24 |
| 1598037467 | David L. Beatty Dpm PC | Podiatrist | 125 N Water St, Paulding, OH 45879-1245 | 2012-02-07 |
| 1750677829 | Elizabeth Gero | Podiatrist | 10701 East Blvd # 112bw, Cleveland, OH 44106-1702 | 2011-06-27 |
| 1841433703 | Home Visit Podiatrists, Inc. | Podiatrist | 2010 Wayland Ave, Cincinnati, OH 45212-3708 | 2009-04-08 |
| 1023250248 | Podiatry Home Health Care | Podiatrist | 5683 Pearl Rd, Parma, OH 44129-2528 | 2009-04-02 |
| 1982850525 | Richard A Raabe Dpm Inc | Podiatrist | 128 Wertz Ave Nw Ste A, Canton, OH 44708 | 2008-08-14 |
| 1225214125 | Louis L. Endress Dpm | Podiatrist | 2914 Cleveland Rd, Wooster, OH 44691-1655 | 2008-01-10 |
| 1457533622 | James D. Robinette, Dpm, Inc. | Podiatrist | 5932 Colerain Ave, Cincinnati, OH 45239-6414 | 2007-11-29 |
| 1336352038 | Laser Foot Care Center, Inc | Podiatrist | 2495 Olentangy Dr, Akron, OH 44333-2831 | 2007-05-08 |
| 1932237922 | Thomas Joseph Javorsky | Podiatrist | 1400 S Hubbard Rd, Lowellville, OH 44436-9411 | 2007-03-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.