NORTHERN OHIO MEDICAL SPECIALISTS LLC – Internal Medicine Physician, NPI 1225085855
Internal Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for NORTHERN OHIO MEDICAL SPECIALISTS LLC
PO BOX 378
SANDUSKY, OH 448710378
Phone: (419) 609-1112
Fax: (419) 609-1123
Type: Mailing
PO BOX 8372
CAROL STREAM, IL 601978372
Phone: (419) 609-1112
Fax: (419) 609-1123
Type: Mailing
PO BOX 631971
CINCINNATI, OH 452631971
Phone: (419) 462-6161
Fax: (419) 502-3511
Type: Mailing
3004, Hayes Avenue, Sandusky County, Ohio, 43420, United States
SANDUSKY, OH 448705321
Phone: (419) 609-1112
Fax: (419) 609-1123
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2019-04-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-07-31 (676 days ago).
Enrollment records
3
Earliest due date
2024-07-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20031126000214 | O | Clinic/Group Practice | OH | TBD |
| O20190207000144 | O | Clinic/Group Practice | PA | 2024-07-31 |
| O20190403000534 | O | Clinic/Group Practice | WV | 2024-08-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 44871)
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