Teresa Ghazoul, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

35-056696 Issued in OH

Practice address

1761 Beall Ave Ste 104
Wooster, OH 44691-2342

Phone

(330) 202-3350

Fax

(330) 202-3356

NPI assigned

Jun 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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 1

Merit-based Incentive Payment System (MIPS)

Final score

81.09 of 100Reported as group

Quality

59.24

Promoting interoperability

99

Improvement activities

40

Cost

78.55

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: teresa.ghazoul@bloomingtonmedical.medicity.net

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.

• Bloomington Medical Services LLC

  • Internal Medicine Physician
  • Wooster, OH
  • NPI 1528246683
  Medicare reassignment NPD

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1265475370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1761 BEALL AVE STE 104",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912342",
            "telephone_number": "330-202-3350",
            "fax_number": "330-202-3356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 BEALL AVE STE 104",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912342",
            "telephone_number": "330-202-3350",
            "fax_number": "330-202-3356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHAZOUL",
        "first_name": "TERESA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "OH",
            "license": "35-056696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0928634",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tghazoul484626@direct.osumc.edu",
            "affiliation": "N",
            "address_1": "715 Richland Mall",
            "city": "Ontario",
            "state": "OH",
            "country_code": "US",
            "postal_code": "449063802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tara R. Gerber, MSW, LSW
• James W Gesler, M.D.
• Anna Kathryn Gest, MS, RDN, LD
• Ghazarian Dental Clinic
• Krikor P. Ghazarian, D.D.S.
• Angela Marie Gianotto, LMT
• Jasmine Giauque
• Charles F Gibson, PHD
• Brooke Gifford, BSW, LSW
• Jessica M Gillman

• Plastic Surgery Physician in Wooster, OH
• Providers in Wooster, OH by specialty
• Plastic Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; 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.