Individual provider Active NPI

Thomas C Fenzl, M.D.

  • Ophthalmology Physician
  • Wooster, OH
National Provider Identifier
1215956818
Registry record updated Oct 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
35.048705 Issued in OH
Practice address
3519 Friendsville Rd
Wooster, OH 44691-1241
Phone
(330) 345-7200
Fax
(330) 345-8029
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 35.048705 OH Primary

Addresses

Primary practice location

3519 Friendsville Rd
Wooster, OH 44691-1241

Mailing address

3519 Friendsville Rd
Wooster, OH 44691-1241
Phone (330) 345-7200

Other identifiers 1

IdentifierTypeStateIssuer
0509588MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.048705OHMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wooster Ophthalmologists, Inc. Current Accepting new patients
Wooster ENT Associates Inc Past Accepting new patients

Locations

3519 Friendsville Rd
Wooster, OH 44691
Phone (330) 345-7200

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: tfenzl@woostereyecenter.ecldirect.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193184000000",
    "number": "1215956818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3519 FRIENDSVILLE RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446911241",
            "telephone_number": "330-345-7200",
            "fax_number": "330-345-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3519 FRIENDSVILLE RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446911241",
            "telephone_number": "330-345-7200",
            "fax_number": "330-345-8029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENZL",
        "first_name": "THOMAS",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35.048705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0509588",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.