Jeremy Clifton Cuzzourt, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

35.125222 Issued in OH

Practice address

98 State St
Proctorville, OH 45669-8163

Phone

(855) 446-5937

Fax

(740) 886-9374

NPI assigned

Jul 5, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 5

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WV, OH2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Otolaryngology

Education

Mercer University School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Holzer Clinic LLCGroup PAC ID 5890606008, 266 clinicians

Premier Therapy and Health Centers IncGroup PAC ID 7416859574, shared by 6 NPIs, 263 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Marys Medical Center Hospital, Huntington, WV, CCN 510007
• Holzer Medical Center Hospital, Gallipolis, OH, CCN 360054
• King'S Daughters' Medical Center Hospital, Ashland, KY, CCN 180009

Merit-based Incentive Payment System (MIPS)

Final score

84.27 of 100Reported as group

Quality

68.56

Promoting interoperability

100

Improvement activities

40

Cost

68.7

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeremy.cuzzourt.1@17389.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Holzer Clinic, LLC

  • Multi-Specialty Clinic/Center
  • Gallipolis, OH
  • NPI 1508817248

  WV

  Medicare reassignment Care Compare group NPD
• I Path LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Gallipolis, OH
  • NPI 1942525563
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Holzer Hospital Foundation

  • Rural Acute Care Hospital
  • Gallipolis, OH
  • NPI 1942256888
  Care Compare affiliation
• Ashland Hospital Corporation

  • General Acute Care Hospital
  • Ashland, KY
  • NPI 1851346720
  Care Compare affiliation
• St. Mary'S Medical Center Inc

  • General Acute Care Hospital
  • Huntington, WV
  • NPI 1164492195
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1013948694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "740-886-9370",
            "fax_number": "740-886-9374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 STATE ST",
            "city": "PROCTORVILLE",
            "state": "OH",
            "postal_code": "456698163",
            "telephone_number": "855-446-5937",
            "fax_number": "740-886-9374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUZZOURT",
        "first_name": "JEREMY",
        "middle_name": "CLIFTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TN",
            "license": "46380",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "WV",
            "license": "22299",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "35.125222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00324289",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2667234",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810005553",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64127202",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1519145",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jeremy.cuzzourt.1@17389.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "98 State St",
            "city": "Proctorville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456698163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gregory Clark
• Amber Rae Clay
• Cross Roads
• Bradley James Curtis
• Grace Kathlynne Curtis
• Celeste M Dalton
• James S. Darlington, D.D.S.
• Glenn Scott Davis, M.D.
• Daystar Services LLC
• Jami Nell Dean, CPHT

• Otolaryngology Physician in Proctorville, OH
• Providers in Proctorville, OH by specialty
• Otolaryngology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.