SAMUEL AGUBOSIM (MD) – Anesthesiology Physician, NPI 1467446682

SAMUEL AGUBOSIM (MD) is a healthcare provider. based in Maumee, Ohio. specializing in ANESTHESIOLOGY. They hold the professional credentials MD. They hold a License No. 35074877 (OH). The NPI Number for SAMUEL AGUBOSIM (MD) is 1467446682

Main info

Male
Sole Proprietor
32 Years Of Experience
Accepts Medicare Assignment
Name
SAMUEL AGUBOSIM (MD)
NPI
1467446682
Phone
(419) 794-1170
Address
1574 HENTHORNE DR
Enumeration Date
2 September 2005
Last Update Date
2 May 2017

Doctor Profile

Medical School Name
UNIVERSITY OF TOLEDO COLLEGE OF MEDICINE
Secondary Phone
7404545000
Graduation Year
1994 (32 years ago)
PAC ID
8426947128
Group Practice PAC ID
0042558066
Professional Enrollment ID
I20040311000925
Address ID
OH437011406ZA2951XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness75
Years active:20State licenses:1Digital endpointsOther names

2,271 ANESTHESIOLOGY in OH

Provider Addresses for SAMUEL AGUBOSIM (MD)

  • 1574 HENTHORNE DR

    SUITE C

    MAUMEE, OH 435371397

    Phone: (419) 794-1170

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 5 Open Payments records for all available years, with a total value of $96.

Total Amount is formed as General ($96) + Research ($0) + Ownership ($0) = $96.

Last reported payment date: 2024-10-15 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($69).

Total Amount

$96

General + Research + Ownership

Payments

5

Total payment records

General Amount

$96

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-15

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-03-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040311000925IAnesthesiologyOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 43537)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0042558066View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YIL
Certified Registered Nurse Anesthetist (Crna)OH
Certified Registered Nurse Anesthetist (Crna)OH
A N E S T H E S I O L O G YOH
Certified Registered Nurse Anesthetist (Crna)OH
Certified Registered Nurse Anesthetist (Crna)OH
A N E S T H E S I O L O G YIL
Certified Registered Nurse Anesthetist (Crna)OH
A N E S T H E S I O L O G YMI
Certified Registered Nurse Anesthetist (Crna)OH

Reviews

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Frequently asked questions

Does SAMUEL AGUBOSIM (MD) have a public NPI I can cite?
Public records show SAMUEL AGUBOSIM (MD) under NPI 1467446682.
Is SAMUEL AGUBOSIM (MD)'s NPI status active today?
Active status means SAMUEL AGUBOSIM (MD)'s NPI record is not deactivated in the public file.
What type of care does SAMUEL AGUBOSIM (MD) provide?
SAMUEL AGUBOSIM (MD)'s profile centers on Anesthesiology Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to SAMUEL AGUBOSIM (MD)?
SAMUEL AGUBOSIM (MD) is associated with Maumee, Ohio in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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