Community Memorial Hospital - Medicare Primary Care in Hicksville, OH

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Community Memorial Hospital is a medicare enrolled primary clinic (General Acute Care Hospital - Critical Access) in Hicksville, Ohio. The current practice location for Community Memorial Hospital is 208 Columbus Street, Hicksville, Ohio. For appointments, you can reach them via phone at (419) 542-6692. The mailing address for Community Memorial Hospital is 208 Columbus Street, Hicksville, Ohio and phone number is (419) 542-6692.

Community Memorial Hospital is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1730145392. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (419) 542-6692.

Contact Information

Community Memorial Hospital
208 Columbus Street
Hicksville
OH 43526
(419) 542-6692
(419) 542-6506

Map and Direction


Primary Care Clinic Profile

Full NameCommunity Memorial Hospital
SpecialityGeneral Acute Care Hospital
Location208 Columbus Street, Hicksville, Ohio
Authorized Official Name and PositionJane Zachrich (CEO)
Authorized Official Contact4195425566
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Community Memorial Hospital
208 Columbus Street
Hicksville
OH 43526

Ph: (419) 542-6692		Community Memorial Hospital
208 Columbus Street
Hicksville
OH 43526

Ph: (419) 542-6692

NPI Details:

NPI Number1730145392
Provider Enumeration Date04/24/2006
Last Update Date08/07/2019

Medicare PECOS Information:

Medicare PECOS PAC ID0547258907
Medicare Enrollment IDO20040504000912

Medical Identifiers

Medical identifiers for Community Memorial Hospital such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1730145392NPI-NPPES
1677841MedicaidOH

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QR1300XClinic/center - Rural Health (* (Not Available))Secondary
282NC0060XGeneral Acute Care Hospital - Critical Access (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Community Memorial Hospital acts as a billing entity for following providers:
Provider NameDaniel J Hoffman
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1669464376
PECOS PAC ID: 5799689857
Enrollment ID: I20031121000069
Provider NameJames B Emerson
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1538155544
PECOS PAC ID: 9133023070
Enrollment ID: I20031121000889
Provider NameSeth A Rosenberg
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1144313164
PECOS PAC ID: 8022910439
Enrollment ID: I20040126000407
Provider NamePantelhs Pete Varlas
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1134156250
PECOS PAC ID: 8123000718
Enrollment ID: I20040607000649
Provider NameScott A Waters
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1235233867
PECOS PAC ID: 6507778966
Enrollment ID: I20040610001370
Provider NameKamran Rafiq
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1942395546
PECOS PAC ID: 7517945009
Enrollment ID: I20040712000207
Provider NameRobert E Barnett
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1033102918
PECOS PAC ID: 6002882081
Enrollment ID: I20040909001463
Provider NameLori Lynn Hockenberry
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1407840721
PECOS PAC ID: 0042274102
Enrollment ID: I20041117001206
Provider NameRowland J Rivero
Provider TypePractitioner - Hospitalist
Provider IdentifiersNPI Number: 1154530368
PECOS PAC ID: 4688630841
Enrollment ID: I20041209000019
Provider NameMarcus Ma
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1336102847
PECOS PAC ID: 2961315072
Enrollment ID: I20050228001051
Provider NameKirk D Crouser
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1972501997
PECOS PAC ID: 1759328131
Enrollment ID: I20050421001287
Provider NameDavid P Rickson
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1376573899
PECOS PAC ID: 0042252496
Enrollment ID: I20050525000769
Provider NameAnthony G Vlastaris
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1124074364
PECOS PAC ID: 2163466509
Enrollment ID: I20050616000007
Provider NameJohn R Desmarais
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1023085834
PECOS PAC ID: 7214955798
Enrollment ID: I20051103000134
Provider NameJohn J Wukie
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1588767883
PECOS PAC ID: 4688671050
Enrollment ID: I20061107000150
Provider NameJeffrey L Justice
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1770584377
PECOS PAC ID: 4789674433
Enrollment ID: I20070130000520
Provider NameMatthew C Grothaus
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1417978776
PECOS PAC ID: 9032118138
Enrollment ID: I20071113000491
Provider NameMichael Kooistra
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1508864380
PECOS PAC ID: 8527166719
Enrollment ID: I20071127000866
Provider NameFrancis K Aona
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1982768255
PECOS PAC ID: 6204917404
Enrollment ID: I20080114000617
Provider NameCraig E Hanson
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1578600565
PECOS PAC ID: 6608886874
Enrollment ID: I20080327000470
Provider NamePatricia Mattevi
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1487739157
PECOS PAC ID: 0143399394
Enrollment ID: I20080514000627
Provider NameJohnathan R Haggerty
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1770744617
PECOS PAC ID: 8628144029
Enrollment ID: I20080909000535
Provider NameDavid Cheng
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1114960630
PECOS PAC ID: 9032116330
Enrollment ID: I20080922000164
Provider NameTodd M Wiley
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1295838134
PECOS PAC ID: 7416000526
Enrollment ID: I20090806000158
Provider NameDuane Johnson
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1750392676
PECOS PAC ID: 7517042880
Enrollment ID: I20090818000427
Provider NameLaverne L Miller
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1477549962
PECOS PAC ID: 0749320216
Enrollment ID: I20091214000378
Provider NameJames H Gray
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1902903230
PECOS PAC ID: 7911804018
Enrollment ID: I20100419000020
Provider NameKathryn A Khandaker
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1417254764
PECOS PAC ID: 0749464436
Enrollment ID: I20110404000750
Provider NameJian Cui
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1639338940
PECOS PAC ID: 1759422116
Enrollment ID: I20111005000720
Provider NameJessica L Slattery
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245518927
PECOS PAC ID: 9537331608
Enrollment ID: I20111013000643
Provider NameLaurie A Barkway
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1003870031
PECOS PAC ID: 9133195506
Enrollment ID: I20120223000345
Provider NameVasavi K Reddy
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1356580294
PECOS PAC ID: 3274658034
Enrollment ID: I20120608000178
Provider NameGabrielle F Morris
Provider TypePractitioner - Neurosurgery
Provider IdentifiersNPI Number: 1912937459
PECOS PAC ID: 6204804925
Enrollment ID: I20140129002004
Provider NameTara L Garza
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1598165888
PECOS PAC ID: 3678794823
Enrollment ID: I20141031001517
Provider NameJeffrey Allen Bender
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1881618205
PECOS PAC ID: 6406859172
Enrollment ID: I20141212001337
Provider NameRicardo G Joseph
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1750342135
PECOS PAC ID: 7911907902
Enrollment ID: I20160203001489
Provider NameRichard Walter Pretorius
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1013900505
PECOS PAC ID: 4688561517
Enrollment ID: I20161004000765
Provider NameMeghan E Wooster
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1710305628
PECOS PAC ID: 1052691789
Enrollment ID: I20161214002269
Provider NameRyan K Bleck
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1568877546
PECOS PAC ID: 3779701123
Enrollment ID: I20170616001861
Provider NameMegan E Ashbacher
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1124544614
PECOS PAC ID: 5395001317
Enrollment ID: I20171108000718
Provider NameJessica J Mendez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1831445055
PECOS PAC ID: 6608008735
Enrollment ID: I20180724000259
Provider NameEllise S Koenn
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1952897092
PECOS PAC ID: 8527317692
Enrollment ID: I20180822002780
Provider NameCrystal Trabel
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1912480039
PECOS PAC ID: 8820341340
Enrollment ID: I20181031001753
Provider NameMichael Tiller
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1114345378
PECOS PAC ID: 5597046573
Enrollment ID: I20191015001551
Provider NameElizabeth A Heitmeyer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1104455344
PECOS PAC ID: 9830511484
Enrollment ID: I20200626002168
Provider NameSatinderjit Singh
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1013203199
PECOS PAC ID: 1759525397
Enrollment ID: I20210715004098
Provider NameAlisha D Hudson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1639750524
PECOS PAC ID: 8022416023
Enrollment ID: I20211005003364
Provider NameStephanie R Ramey
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1811661895
PECOS PAC ID: 2264820091
Enrollment ID: I20211028001373
Provider NameAkhter Saeed
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1699783340
PECOS PAC ID: 8921236449
Enrollment ID: I20230309000525

Reviews and Comments


General Acute Care Hospital in Hicksville, OH

Community Memorial Hospital
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 208 Columbus St, Hicksville, OH 43526
Phone: 419-542-6692    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.