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Deactivated NPI 1366429524 Deactivated / Inactive NPI Male Practitioner

Dr. Richard John Nelson , MD

Specialist • Maumee, OH

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Richard Nelson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 29, 2005
NPI Deactivation Date November 20, 2020
Total Practice Duration ~15 Years of Practice (2005 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. Richard Nelson, MD was a registered Specialist practicing in Maumee, OH. Throughout an active medical career spanning 15 years, Dr. Nelson provided care at the practice location at 6005 MONCLOVA RD until profile deactivation on 2020-11-20.

Historical Medicare Part B clinical services included established patient outpatient office visit, new patient outpatient office visit, removal of impacted ear wax. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

6005 Monclova Rd
Suite 320

Maumee, OH 435371864

Telephone 4195787555
Fax 4195396336
Associated Practice Facility / Clinic
🏢 Toledo Ent Inc Facility NPI 1437257474

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Maumee, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 36.0 Yrs
State Avg: 37.3 Yrs
Regional Practice Density
7 Specialists

Practicing in Maumee, OH (1444 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
52.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2018)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
177 122 $92.00 $69.85
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
66 66 $145.00 $103.85
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
42 37 $128.00 $103.62
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more
28 27 $65.00 $41.83
69210 Removal of impacted ear wax
27 20 $98.00 $46.99
43200 Diagnostic exam of esophagus using a flexible endoscope through mouth
27 13 $692.00 $74.48
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
24 24 $199.00 $159.20
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more
17 17 $241.00 $200.39
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more
16 11 $185.00 $139.86
31579 Exam to assess movement of vocal cord flaps using an endoscope
12 12 $474.00 $171.68

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License OH 35-062389

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

24 Associated Practitioners
Jeromy Balduf , PA-C, RDN

Physician Assistant

NPI 1003561309

Physician Assistant (Certified), Registered Dietitian Nutritionist

Caitlyn Liebich , FNP-C

Nurse Practitioner - Family

NPI 1194448027

Family Nurse Practitioner (Certified)

NPI 1255358032

Doctor of Medicine (M.D.)

Heidi Conklin , CNP

Nurse Practitioner - Family

NPI 1265686703

Certified Nurse Practitioner

Brittany Mosley , CNP

Nurse Practitioner - Family

NPI 1295417483

Certified Nurse Practitioner

Emily Stimes , PA

Physician Assistant

NPI 1346007655

Physician Assistant

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
⚠️
NPI Profile Deactivated November 20, 2020

Record deactivated on November 20, 2020

NPI Profile Active June 26, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location June 26, 2014

Registered at 6005 MONCLOVA RD, SUITE 320, MAUMEE, OH 435371864 (Tel: 4195787555)

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Updated Business Mailing Address June 26, 2014

Registered at 6005 MONCLOVA RD, SUITE 320, MAUMEE, OH 435371864 (Tel: 4195787555)

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Provider Name / Credentials Updated June 26, 2014

Recorded as RICHARD NELSON, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 26, 2014

Specialist (License #35-062389 in OH)

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Initial NPI Registration & Enumeration December 29, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1366429524
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 29, 2005
Last Update: June 26, 2014
Deactivation Date: November 20, 2020

Mailing Address

6005 Monclova Rd, Suite 320

Maumee, OH 435371864

Phone: 4195787555

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.