MRS. MARY RUTH GORNIAK (CNM, FNP) – Advanced Practice Midwife, NPI 1699817874

MRS. MARY RUTH GORNIAK (CNM, FNP) is a healthcare provider. based in Beavercreek, Ohio. specializing in CERTIFIED NURSE MIDWIFE (CNM). They hold the professional credentials CNM, FNP. They hold a License No. NP-00786 (OH). The NPI Number for MRS. MARY RUTH GORNIAK (CNM, FNP) is 1699817874

Main info

Female
30 Years Of Experience
Accepts Medicare Assignment
Name
MRS. MARY RUTH GORNIAK (CNM, FNP)
NPI
1699817874
Phone
(937) 426-8122
Address
624 SOUTHERN BELLE BLVD
Enumeration Date
13 February 2007
Last Update Date
11 September 2025

Doctor Profile

Medical School Name
WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE
Secondary Phone
9372816800
Graduation Year
1996 (30 years ago)
PAC ID
1557585387
Group Practice PAC ID
9335300904
Professional Enrollment ID
I20140617000994
Address ID
OH453851810XE360XXDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness85
Years active:19State licenses:2Digital endpointsOther names

298 CERTIFIED NURSE MIDWIFE (CNM) in OH

Provider Addresses for MRS. MARY RUTH GORNIAK (CNM, FNP)

  • 624 SOUTHERN BELLE BLVD

    BEAVERCREEK, OH 454346200

    Phone: (937) 426-8122

    Type: Mailing

  • 1 WYOMING ST

    DAYTON, OH 454092722

    Phone: (937) 208-2007

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $39.

Total Amount is formed as General ($39) + Research ($0) + Ownership ($0) = $39.

Last reported payment date: 2024-10-23 • Largest payer in this snapshot: Exact Sciences Corporation ($20).

Total Amount

$39

General + Research + Ownership

Payments

2

Total payment records

General Amount

$39

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-23

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: 2014-06-17

PECOS data refreshed: 2026-06-15

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
I20140617000994ICertified Nurse Midwife (Cnm)OHTBD

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 45434)

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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: 9335300904View full group profile
NameSpecialtyState
Family PracticeOH
Nurse PractitionerOH
Family PracticeOH
Internal MedicineOH
Nurse PractitionerOH
Family PracticeOH
P O D I A T R YOH
Nurse PractitionerOH
Family PracticeOH
Family PracticeOH

Reviews

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Frequently asked questions

What unique ID ties claims to MRS. MARY RUTH GORNIAK (CNM, FNP)?
NPI 1699817874 is assigned to MRS. MARY RUTH GORNIAK (CNM, FNP) under the national enumeration system.
Is MRS. MARY RUTH GORNIAK (CNM, FNP)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does MRS. MARY RUTH GORNIAK (CNM, FNP) treat or focus on?
Patients typically see MRS. MARY RUTH GORNIAK (CNM, FNP) under the specialty Advanced Practice Midwife. Clinical services aligned with this taxonomy classification.
Where is MRS. MARY RUTH GORNIAK (CNM, FNP)'s primary listing?
We display Beavercreek, Ohio because that is what the record indicates for MRS. MARY RUTH GORNIAK (CNM, FNP).
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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