SANDUSKY FAMILY PRACTICE INC
NPI 1396816708
Family Medicine in Sandusky, OH

Q: What is Sandusky Family Practice Inc's NPI number?

The NPI number for Sandusky Family Practice Inc is 1396816708. It was assigned to this organization in the NPPES registry on November 10, 2006.

Q: What is Sandusky Family Practice Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since November 10, 2006CLIA 36D0709272 · Microscopy

3103 CAMPBELL ST, SANDUSKY, OH 44870(419) 625-4461(419) 625-5199 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Sandusky Family Practice Inc NPPES

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

SANDUSKY FAMILY PRACTICE INC (NPI 1396816708) is a healthcare organization registered as a family medicine in Sandusky, Ohio and active in the NPI registry since November 2006. The organization holds a CLIA Microscopy certificate valid through March 31, 2028 and lists James Jefferson Wysor, Physician, as its authorized official.

NPPES Registry Identity

NPI1396816708

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameSANDUSKY FAMILY PRACTICE INC

Location Address3103 CAMPBELL STSandusky, OH 44870-7230

Mailing Address3103 Campbell StSandusky, OH 44870-7230 · (419) 625-4461 · Fax (419) 625-5199

Phone(419) 625-4461

Fax(419) 625-5199

Organization SubpartNo

Authorized OfficialJames Jefferson WysorPhysician · (419) 625-4461

Enumeration DateNovember 10, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1396816708 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in OH · 35-047619

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

3103 CAMPBELL ST, Sandusky, OH 44870

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Other Identifiers 5

Other000000131843OH · Anthem

Other04375OH · Paramount

Other20636020100OH · Bwc

Medicaid0538681OH

Other206360201001OH · Med Mutual Of Ohio

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sandusky Family Practice Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Sandusky Family Practice Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Richard Keller, MD

Family Practice

NPI 1356314421

3103 CAMPBELL ST
Sandusky, OH 44870

(419) 625-4461

✔ PECOS✔ Accepts MedicareSame address

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 36D0709272

Sandusky Family Practice Inc · Sandusky, OH

Active · expires Mar 31, 2028

CLIA Number36D0709272

Laboratory TypePhysician Office

Certificate Effective DateApril 1, 2026

Certificate Expiration DateMarch 31, 2028

Laboratory DirectorRichard R. Keller

Laboratory Phone(419) 625-4461

Laboratory LocationSandusky Family Practice Inc3103 Campbell Street, Sandusky, OH 44870

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Sandusky Family Practice Inc's NPI number?

The NPI number for Sandusky Family Practice Inc is 1396816708. It was assigned to this organization in the NPPES registry on November 10, 2006.

Where is Sandusky Family Practice Inc located?

Sandusky Family Practice Inc is located at 3103 Campbell St, Sandusky, OH 44870. The listed phone number is (419) 625-4461.

What is Sandusky Family Practice Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Sandusky Family Practice Inc enrolled in Medicare?

Yes. Sandusky Family Practice Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Sandusky Family Practice Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Sandusky Family Practice Inc. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Sandusky Family Practice Inc hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 36D0709272) is associated with this NPI, valid through March 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Sandusky Family Practice Inc accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource and Molina Healthcare list Sandusky Family Practice Inc 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.

When was this NPI record last updated?

The NPPES record for Sandusky Family Practice Inc was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.