MARC ERIK NELSON M.D.
NPI 1659359644
Otolaryngology - Pediatric Otolaryngology in Dayton, OH
NPI Status: Active since January 09, 2006
Contact Information
1 CHILDRENS PLZ
DAYTON, OH
ZIP 45404
Phone: (937) 641-4000
Fax: (937) 641-4500
- Individual
- Male
- Years of Experience 28
- Otolaryngology
- Pediatric Otolaryngology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About MARC NELSON
This page provides the complete NPI Profile along with additional information for Marc Nelson, a provider established in Dayton, Ohio with a medical specialization in Otolaryngology, focusing in pediatric otolaryngology and more than 28 years of experience. He graduated from University Of Chicago, Pritzker School Of Medicine in 1998. The healthcare provider is registered in the NPI registry with number 1659359644 assigned on January 2006. The practitioner's primary taxonomy code is 207YP0228X with license number 35.084096 (OH). The provider is registered as an individual and his NPI record was last updated February 2026.
- NPI
- 1659359644
- Provider Name
- MARC ERIK NELSON M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1 CHILDRENS PLZ DAYTON, OH 45404
- Location Phone
- (937) 641-4000
- Location Fax
- (937) 641-4500
- Mailing Address
- PO BOX 933432 CLEVELAND, OH 44193
- Mailing Phone
- (937) 641-5072
- Mailing Fax
- (937) 641-4500
- Medical School Name
- UNIVERSITY OF CHICAGO, PRITZKER SCHOOL OF MEDICINE
- Graduation Year
- 1998
- Is Sole Proprietor?
- No
- Enumeration Date
- 01-09-2006
- Last Update Date
- 02-13-2026
- Code Navigator
Location Map
Secondary Locations
- 3333 W Tech Rd
Miamisburg, OH 45342
(937) 641-4000 - 3535 Southern Blvd
Kettering, OH 45429
(937) 641-4000 - 865 W Market St
Troy, OH 45373
(937) 641-4000
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Otolaryngology Pediatric Otolaryngology
- Taxonomy Code
- 207YP0228X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 35.084096
- License State
- OH
- Taxonomy Description
- A pediatric otolaryngologist has special expertise in the management of infants and children with disorders that include congenital and acquired conditions involving the aerodigestive tract, nose and paranasal sinuses, the ear and other areas of the head and neck. The pediatric otolaryngologist has special skills in the diagnosis, treatment, and management of childhood disorders of voice, speech, language and hearing.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | 35-084096N (OH) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Standard - HMO
- Gold Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Standard - HMO
- Bronze $8,300 w/ Adult Dental ON-EX - HMO
- Bronze $8,300 w/ Virtual & Wellness ON-EX - HMO
- Bronze HSA $7,300 ON-EX - HMO
- Bronze Standard w/ Virtual & Wellness - HMO
- Gold $1,000 w/ Adult Dental ON-EX - HMO
- Gold $1,000 w/ Virtual & Wellness ON-EX - HMO
- Gold $500 w/ Virtual & Wellness ON-EX - HMO
- Gold Standard w/ Virtual & Wellness - HMO
- Silver $5,000 w/ Adult Dental ON-EX - HMO
- Silver $5,000 w/ Virtual & Wellness ON-EX - HMO
- SummaCare Bronze 10600 with 3 Free PCP Visits - HMO
- SummaCare Bronze 10600 with 3 Free PCP Visits + Adult Vision - HMO
- SummaCare Bronze 8000 - HMO
- SummaCare Bronze 8000 with Adult Vision Exam - HMO
- SummaCare Gold 1000 with 3 Free PCP Visits + Adult Vision - HMO
- SummaCare Gold 2000 with 3 Free PCP Visits - HMO
- SummaCare Gold 2000 with 3 Free PCP Visits + Adult Vision - HMO
- SummaCare Silver 3500 with 3 Free PCP Visits + Adult Vision - HMO
- SummaCare Silver 5000 1000 Rx with 3 Free PCP Visits - HMO
- SummaCare Silver 6000 with 3 Free PCP Visits + Adult Vision - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
- UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Standard+ (Dental + Vision, No Referrals) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Standard (No Referrals) - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2476495 | MEDICAID (05) | OH |
Medicare Participation & PECOS Enrollment Status
Marc Nelson is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Marc Nelson is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 3870572555
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20040715001477
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1659359644, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 76. The final step is to find the difference between that total and the next multiple of ten (80 - 76 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 76 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
DAYTON, OH 45404
DAYTON, OH 45404
DAYTON, OH 45404
DAYTON, OH 45404
DAYTON, OH 45404
DAYTON, OH 45404
DAYTON, OH 45404
DAYTON, OH 45404
DAYTON, OH 45404
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1659359644, enumerated as an "individual" on January 09, 2006.
The provider is located at 1 CHILDRENS PLZ DAYTON, OH 45404 and the phone number is (937) 641-4000.
Otolaryngology with taxonomy code 207YP0228X and a focus in Pediatric Otolaryngology.
The provider might be accepting Accepts: Antidote Health Plan of Ohio, Inc., MedMutual,. Please consult your insurance carrier or call the provider to verify.
