Demetrio J. Agcaoili, M.D.
Individual provider Active NPI Infectious Disease Physician · Saint Clarisville, OH
NPI 1124040951 · NPPES record last updated Jul 23, 2020
Key facts
- NPI
- 1124040951
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Infectious Disease Physician 207RI0200X
- License
- 21203 (WV)
- Practice address
- 51520 National Road E
Suite 5
Saint Clarisville, OH 43950-8213 - Phone
- (740) 296-5931
- Fax
- (740) 296-5942
- NPI assigned
- Jul 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Infectious Disease
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
51520 National Rd
Suite 5
Saint Clairsville, OH 43950-8213
Phone (304) 639-1433
51520 National Rd E
Suite 5
Saint Clairsville, OH 43950-8213
Hospital & facility affiliations
- Wvuhs Home Care
- Wheeling Hospital, Inc
- Barnesville Hospital Association, Inc
- Reynolds Memorial Hospital, Inc
- West Virginia University Hospitals, Inc
- Wetzel County Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OH, WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040301000959 | OH | Practitioner - Infectious Disease |
0648167015 |
Reassigns benefits to 1 organization Practice locations: Saint Clairsville, OH |
| I20061218000209 | WV | Practitioner - Infectious Disease | 0648167015 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21203 | WV | MD | Infectious Disease Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | 21203 | WV | Yes |
Addresses
Primary practice location
51520 National Road E
Suite 5
Saint Clarisville, OH 43950-8213
Mailing address
51520 National Road E
Suite 5
Saint Clarisville, OH 43950-8213
Phone (740) 296-5931
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841957000 | Medicaid | WV | |
| 2413267 | Medicaid | OH |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.