PROMEDICA GENITO-URINARY SURGEONS LLC (NPI# 1366795221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366795221 |
| Entity Type | Organization |
| Organization Name | PROMEDICA GENITO-URINARY SURGEONS LLC |
| Practice Address |
1 Seagate Ste 800 Toledo OH 43604-1558 |
| Practice Telephone | 4198247250 |
| Practice Fax Number | 4198853921 |
| Mailing Telephone | 4198247250 |
| Mailing Fax Number | 4198853921 |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2018-02-19 |
| Authorized Official Name | AMY L DWYER (CREDENTIALING SUPERVISOR) |
| Authorized Official Telephone | 5675851934 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | OH | Allopathic & Osteopathic Physicians | |
| N | 363A00000X | Physician Assistant | OH | Physician Assistants & Advanced Practice Nursing Providers | |
| N | 363L00000X | Nurse Practitioner | OH | Physician Assistants & Advanced Practice Nursing Providers | |
| N | 367500000X | Nurse Anesthetist, Certified Registered | OH | Physician Assistants & Advanced Practice Nursing Providers | |
| Y | 208800000X | Urology | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0076667 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922422997 | Promedica Genito-urinary Surgeons LLC | Urology | 7640 Sylvania Ave, Suite L, Sylvania, OH 43560-9729 | 2014-02-12 |
| 1184051468 | Promedica Genito-urinary Surgeons LLC | Urology | 5757 Monclova Rd, Suite 6, Maumee, OH 43537-1863 | 2013-10-02 |
| 1477980753 | Promedica Genito-urinary Surgeons LLC | Urology | 605 3rd Ave Ste A, Suite B, Fremont, OH 43420-3269 | 2013-10-02 |
| 1386071652 | Promedica Genito-urinary Surgeons LLC | Urology | 970 W Wooster St, Suite 129, Bowling Green, OH 43402-2643 | 2013-10-02 |
| 1477990893 | Promedica Genito-urinary Surgeons LLC | Urology | 121 Westfield Dr, Archbold, OH 43502-1056 | 2013-05-24 |
| Street Address |
1 SEAGATE STE 800 |
| City | TOLEDO |
| State | OH |
| Zip Code | 43604-1558 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396126314 | Jennifer Ruckstuhl | Nurse Practitioner | 1 Seagate Ste 800, Toledo, OH 43604-1558 | 2015-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346879590 | Kaushal B Jani | Student in an Organized Health Care Education/Training Program | Saint Vincent Medical Center, 2200 Jefferson Ave, Toledo, OH 43604 | 2020-04-08 |
| 1548807316 | Jennifer Marie Bismack | Peer Specialist | 142 23rd St, Suite 911, Toledo, OH 43604 | 2019-11-29 |
| 1841849064 | Keith Allen Vore | Student in an Organized Health Care Education/Training Program | 1117 Jefferson #214, Toledo, OH 43604 | 2019-09-10 |
| 1740846765 | Mohammad Shahrukh Tanweer | Student in an Organized Health Care Education/Training Program | Mercy Health-st. Vincent Medical Center, 2200 Jefferson Avenue, Toledo, OH 43604 | 2019-05-15 |
| 1740846229 | Sami Al-rahman Syed | Student in an Organized Health Care Education/Training Program | Mercy Health - St. Vincent, 2200 Jefferson Ave., Toledo, OH 43604 | 2019-05-10 |
| 1306402870 | Poojitha Kolluri | Student in an Organized Health Care Education/Training Program | 2200 Jefferson Avenue - Mercy Family Physician, Toledo, OH 43604 | 2019-05-10 |
| 1407375090 | Keyana Renee Galloway | Social Worker | 500 Madison Ave Ste 300, Toledo, OH 43604 | 2017-09-14 |
| 1467979302 | Courtney Lorraine Wilson | Physical Therapy Assistant | 1609 N. Summit St, Toledo, OH 43604 | 2017-08-22 |
| 1811426208 | Rosamaria Sanchez | Counselor | 701 Jefferson Ave Suite 101, Toledo, OH 43604 | 2017-06-08 |
| 1306373014 | Salwa Beydoun | Social Worker | 701 Jefferson, Toledo, OH 43604 | 2017-05-12 |
| Find all providers in zip 43604 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679811145 | Hosea Payne | Urology | 3655 Lainar Dr, Toledo, OH 43606-1028 | 2013-01-17 |
| 1780978866 | Hesham Ibrahim Mostafa | Urology | 3020 N Mccord Rd Ste 100, Toledo, OH 43615-1701 | 2011-06-06 |
| 1003893413 | Carin V Hopps | Urology | 2120 W Central Ave, Toledo, OH 43606-3834 | 2005-12-28 |
| 1356337521 | Michael A Rees | Urology | 1125 Hospital Drive, Toledo, OH 43614 | 2005-09-23 |
| 1881691640 | Salvador E Peron | Urology | 3436 Granite Cir, Toledo, OH 43617-1160 | 2005-07-07 |
| 1124022504 | Mayer L. Wainstein | Urology | 3500 Executive Pkwy, Toledo, OH 43606-1319 | 2005-06-13 |
| 1114314556 | David Fumo Jr. | Urology | 2120 W Central Ave, Toledo, OH 43606-3834 | 2015-04-23 |
| 1003208026 | Philip Wong | Urology | 2120 W Central Ave, Toledo, OH 43606-3834 | 2015-02-27 |
| 1629310966 | Sarah Kathryn Perz | Urology | 2120 W Central Ave, Toledo, OH 43606-3834 | 2013-03-25 |
| 1376801027 | Daniel Sullivan Murtagh Jr. | Urology | 3000 Arlington Ave, Graduate Medical Education, Ms 1050, Toledo, OH 43614 | 2012-05-01 |
| Find all providers in TOLEDO | ||||
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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.