MAGRUDER MEDICAL GROUP LTD – Family Medicine Physician, NPI 1871015578
Family Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MAGRUDER MEDICAL GROUP LTD
1250 Fulton St
Port Clinton, OH 434529296
Phone: (419) 734-5587
Fax: (419) 732-1553
Type: Location
11697 W State Route 163
Oak Harbor, OH 434499113
Phone: (419) 898-0993
Fax: (419) 898-2444
Type: Location
1297 W Main St
Marblehead, OH 434402002
Phone: (419) 798-4418
Fax: (419) 798-4442
Type: Location
2861 E Harbor Rd
Port Clinton, OH 434522665
Phone: (419) 732-1833
Fax: (419) 732-0383
Type: Location
611 Fulton St Ste C
Port Clinton, OH 434522008
Phone: (419) 732-6500
Fax: (419) 732-1512
Type: Location
611 Fulton St Ste G
Port Clinton, OH 434522008
Phone: (419) 732-8837
Fax: (419) 734-6658
Type: Location
621 Fulton St
Port Clinton, OH 434522034
Phone: (419) 732-6520
Fax: (419) 734-5414
Type: Location
730 Jefferson St
Port Clinton, OH 434522414
Phone: (419) 301-4335
Fax: (419) 734-2135
Type: Location
Magruder Hospital, 615, Fulton Street, Port Clinton, Ottawa County, Ohio, 43452, United States
PORT CLINTON, OH 434522001
Phone: (419) 734-3131
Fax: (419) 732-8145
Type: Mailing
611 FULTON ST STE E
PORT CLINTON, OH 434522008
Phone: (419) 734-4539
Fax: (419) 734-6365
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: 2017-09-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-09-30 (981 days ago).
Enrollment records
1
Earliest due date
2023-09-30
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 |
|---|---|---|---|---|
| O20170926004144 | O | Clinic/Group Practice | OH | 2023-09-30 |
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 43452)
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