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PAULA SPROW NP
NPI 1396720124
Nurse Practitioner in Defiance, OH

Active since December 14, 2005PECOS EnrolledAccepts Medicare Assignment
1250 RALSTON AVE, SUITE 204, DEFIANCE, OH 43512(419) 782-8332(419) 782-6855 Get Directions Write a Review

NPPES record last updated: November 29, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 3, 2023, May 19, 2022 (2 updates tracked since 2022).

About Paula Sprow Np NPPES

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

PAULA SPROW NP (NPI 1396720124) is an individual nurse practitioner in Defiance, Ohio, licensed in Ohio (NP-07120) and active in the NPI registry since December 2005. She is enrolled in Medicare PECOS, is affiliated with Promedica Toledo Hospital, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1396720124
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NamePAULA SPROWCredential: NP
Location Address1250 RALSTON AVE, SUITE 204Defiance, OH 43512-5311
Mailing Address1250 Ralston Ave, Suite 204Defiance, OH 43512-5311 · (419) 782-8332 · Fax (419) 782-6855
Phone(419) 782-8332
Fax(419) 782-6855
Sole ProprietorNo
Medical School CMSOtherGraduated 2002
Enumeration DateDecember 14, 2005
Last NPPES UpdateNovember 29, 20232 updates tracked since enumeration
✔ NPI 1396720124 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in OH · NP-07120
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
1250 RALSTON AVE, Defiance, OH 43512
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Other Identifiers 2

Other000000379388OH · Anthem
Medicaid2441290OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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

Paula Sprow Np 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 ID3779511159
PECOS Enrollment IDI20051028000778
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 Paula Sprow reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Promedica Central Physicians
50 mi
Family Medicine
100 MADISON AVE, MSC-S38805
Toledo, OH 43604
  • Reassigned Medicare billing, Ohio enrollment
  • 1,072 clinicians in this Medicare group
NPI 1043270150 (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 9

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 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.
75 services51 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
60 services40 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
45 services45 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
40 services36 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
27 services27 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
27 services27 patients

Hospital Affiliations CMS Care Compare 2

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

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

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 43512 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 17

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

BETH A BESAW MD
Family Medicine
1250 RALSTON AVE, SUITE 104
DEFIANCE, OH 43512
Defiance County (419) 783-6995
DEFIANCE REGIONAL MEDICAL CENTER
Social Worker (Clinical)
1250 RALSTON AVE, SUITE 105
DEFIANCE, OH 43512
Defiance County (419) 783-6805
STANISLAW P DAJCZAK MD
Orthopaedic Surgery
1250 RALSTON AVE, SUITE 102
DEFIANCE, OH 43512
Defiance County (419) 783-6996
BETHANY ANNE GRAHAM CNP
Nurse Practitioner
1250 RALSTON AVE, SUITE 204
DEFIANCE, OH 43512
Defiance County (419) 782-8332
DAVID E WINNER MD
Family Medicine
1250 RALSTON AVE, SUITE 104
DEFIANCE, OH 43512
Defiance County (419) 784-3044
ROSEMARY K REITER MD
Family Medicine
1250 RALSTON AVE, SUITE 204
DEFIANCE, OH 43512
Defiance County (419) 782-8332
JOE W SAYRE MD
Surgery
1250 RALSTON AVE, SUITE 203
DEFIANCE, OH 43512
Defiance County (419) 783-6997
DR. JOSHUA MICHAEL LUCAS M.D.
Family Medicine
1250 RALSTON AVE, SUITE 204
DEFIANCE, OH 43512
Defiance County (419) 782-8332

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 Paula Sprow's NPI number?

The NPI number for Paula Sprow is 1396720124. It was assigned to this individual provider in the NPPES registry on December 14, 2005.

Where is Paula Sprow located?

Paula Sprow practices at 1250 Ralston Ave Suite 204, Defiance, OH 43512. The listed phone number is (419) 782-8332.

What is Paula Sprow's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Paula Sprow enrolled in Medicare?

Yes. Paula Sprow 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 Paula Sprow's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Paula Sprow reassigns Medicare benefits to Promedica Central 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 Paula Sprow's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Paula Sprow accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 2 other insurers list Paula Sprow 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 Paula Sprow affiliated with any hospitals?

According to CMS data, Paula Sprow is affiliated with Promedica Toledo Hospital and Promedica Defiance Regional Hospital.

When was this NPI record last updated?

The NPPES record for Paula Sprow was last updated on November 29, 2023. 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.