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DOUGLAS RUMBAUGH
NPI 1164274429
Nurse Practitioner - Acute Care in Toledo, OH

Active since April 02, 2024PECOS EnrolledAccepts Medicare Assignment
2109 HUGHES DR STE 450, TOLEDO, OH 43606(419) 291-2003 Get Directions Write a Review

NPPES record last updated: June 6, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 6, 2024, Apr 2, 2024 (2 updates tracked since 2024).

About Douglas Rumbaugh NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DOUGLAS RUMBAUGH (NPI 1164274429) is an individual acute care provider in Toledo, Ohio, licensed in Ohio (APRN.CNP.0035967) and active in the NPI registry since April 2024. He is enrolled in Medicare PECOS, is affiliated with Promedica Charles And Virginia Hickman Hospital, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1164274429
Entity TypeIndividualMale
Primary Taxonomy363LA2100X
Provider Legal NameDOUGLAS RUMBAUGH
Location Address2109 HUGHES DR STE 450Toledo, OH 43606-5102
Mailing Address27649 Coressel RdDefiance, OH 43512-8783
Phone(419) 291-2003
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateApril 2, 2024
Last NPPES UpdateJune 6, 20242 updates tracked since enumeration
NPPES CertifiedJune 6, 2024
✔ NPI 1164274429 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in OH · APRN.CNP.0035967
2109 HUGHES DR STE 450, Toledo, OH 43606
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Douglas Rumbaugh is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9537500046
PECOS Enrollment IDI20240515002735, I20240911001719
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Douglas Rumbaugh reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Promedica Multi Specialty Physicians
3.6 mi
Family Medicine
100 MADISON AVE, MSC-S38805
Toledo, OH 43604
  • Reassigned Medicare billing, Michigan and Ohio enrollments
  • 83 clinicians in this Medicare group
NPI 1306105150 (567) 585-1964

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
67 services65 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
30 services30 patients
New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202
This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.
12 services12 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Promedica Charles And Virginia Hickman Hospital

Acute Care Hospitals · Adrian, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230005
Location5640 N Adrian HighwayAdrian, MI 49221 · Lenawee County
Emergency services Birthing friendly

Promedica Monroe Regional Hospital

Acute Care Hospitals · Monroe, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number230099
Location718 N Macomb StMonroe, MI 48162 · Monroe County
Emergency services Birthing friendly

Promedica Toledo Hospital

Acute Care Hospitals · Toledo, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360068
Location2142 North Cove BoulevardToledo, OH 43606 · Lucas County
Emergency services Birthing friendly

Memorial Hospital

Acute Care Hospitals · Fremont, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number360156
Location715 South Taft AvenueFremont, OH 43420 · Sandusky County
Birthing friendly

Promedica Defiance Regional Hospital

Critical Access Hospitals · Defiance, OH
OwnershipVoluntary non-profit - Private
CMS Certification Number361328
Location1200 Ralston AvenueDefiance, OH 43512 · Defiance County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43606 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DREW RANDALL OOSTRA M.D.
Internal Medicine (Hematology & Oncology)
2109 HUGHES DR STE 450
TOLEDO, OH 43606
Lucas County (419) 291-2003
ITIYA S FELIX AGACNP
Nurse Practitioner
2109 HUGHES DR STE 450
TOLEDO, OH 43606
Lucas County (419) 291-2003
DR. GREGORY W WALKER D.O.
Surgery (Vascular Surgery)
2109 HUGHES DR STE 450
TOLEDO, OH 43606
Lucas County (419) 251-3112
BRETT GREGORY APLIN MD
Surgery (Vascular Surgery)
2109 HUGHES DR STE 450
TOLEDO, OH 43606
Lucas County (419) 291-2003
KATE MARIE GATES DO
Surgery (Vascular Surgery)
2109 HUGHES DR STE 450
TOLEDO, OH 43606
Lucas County (419) 291-2003
DR. JIHAD T ABBAS M.D.
Surgery (Vascular Surgery)
2109 HUGHES DR STE 450
TOLEDO, OH 43606
Lucas County (419) 291-2003
MRS. KELLI M DONOVAN PA
Physician Assistant
2109 HUGHES DR STE 450
TOLEDO, OH 43606
Lucas County (419) 291-2003
RICHARD SIMMAN M.D.
Surgery (Plastic and Reconstructive Surgery)
2109 HUGHES DR STE 450
TOLEDO, OH 43606
Lucas County (419) 291-2003

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Douglas Rumbaugh's NPI number?

The NPI number for Douglas Rumbaugh is 1164274429. It was assigned to this individual provider in the NPPES registry on April 2, 2024.

Where is Douglas Rumbaugh located?

Douglas Rumbaugh practices at 2109 Hughes Dr Ste 450, Toledo, OH 43606. The listed phone number is (419) 291-2003.

What is Douglas Rumbaugh's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Douglas Rumbaugh enrolled in Medicare?

Yes. Douglas Rumbaugh is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Douglas Rumbaugh's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Douglas Rumbaugh reassigns Medicare benefits to Promedica Multi Specialty Physicians (Toledo, OH). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Douglas Rumbaugh's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Douglas Rumbaugh accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, CareSource and MedMutual and 1 other insurer list Douglas Rumbaugh as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Douglas Rumbaugh affiliated with any hospitals?

According to CMS data, Douglas Rumbaugh is affiliated with Promedica Charles And Virginia Hickman Hospital, Promedica Monroe Regional Hospital, Promedica Toledo Hospital, Memorial Hospital and Promedica Defiance Regional Hospital.

When was this NPI record last updated?

The NPPES record for Douglas Rumbaugh was last updated on June 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.