MEDICARE: MAYFIELD SPINE SURGERY CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center	0834AS	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00937770	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174852461
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAYFIELD SPINE SURGERY CENTER LLC

Provider Business Mailing Address
First Line	:	4020 SMITH RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45209-1936
Country	:	US
Telephone Number	:	513-619-5899
Fax Number	:	513-619-5897

Provider Business Practice Location Address
First Line	:	4020 SMITH RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45209-1936
Country	:	US
Telephone Number	:	513-619-5899
Fax Number	:	513-619-5897

Authorized Official
Title or Position	:	AO
Name	:	ERICA LYNN WEHRMEISTER
Credential	:
Telephone Number	:	314-800-2058

Provider Enumeration Date	:	12/15/2009
Last Update Date	:	10/08/2025

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