Robert Gerard Idzakovich, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN391062 Issued in OH

Practice address

2511 Grandview Ave
Portsmouth, OH 45662-2770

Phone

(740) 464-8125

NPI assigned

Mar 8, 2016

Last updated

Mar 8, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of Cincinnati College of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Holzer Clinic LLCGroup PAC ID 5890606008, 266 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holzer Medical Center Hospital, Gallipolis, OH, CCN 360054
• Holzer Medical Center Jackson Hospital, Jackson, OH, CCN 361320
• St Marys Medical Center Hospital, Huntington, WV, CCN 510007
• Holzer Medical Center Inpatient rehabilitation facility, Gallipolis, OH, CCN 36T054

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Holzer Clinic, LLC

  • Multi-Specialty Clinic/Center
  • Gallipolis, OH
  • NPI 1508817248
  Medicare reassignment Care Compare group NPD
• Apogee Medical Group Ohio Inc

  • Internal Medicine Physician
  • Ashtabula, OH
  • NPI 1477500999
  Medicare reassignment NPD

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

• Holzer Hospital Foundation

  dba Holzer Rehabilitation Unit

  • Rehabilitation Hospital Unit
  • Gallipolis, OH
  • NPI 1396829966

  Inpatient rehabilitation facility

  Care Compare affiliation
• Holzer Hospital Foundation

  • Rural Acute Care Hospital
  • Gallipolis, OH
  • NPI 1942256888
  Care Compare affiliation
• Holzer Medical Center Jackson

  • Critical Access Hospital
  • Jackson, OH
  • NPI 1669410940
  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": "1457395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1275994048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 GRANDVIEW AVE",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622770",
            "telephone_number": "740-464-8125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 GRANDVIEW AVE",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622770",
            "telephone_number": "740-464-8125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDZAKOVICH",
        "first_name": "ROBERT",
        "middle_name": "GERARD",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-08",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "RN391062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chanelle Hussey
• Michelle Mae Hutchinson
• Tracie Hutchinson
• Courtney Douglas Hylton
• Ibrahim M Zayneh MD LLC
• Stacie Ingram, CDCA
• Tsuyoshi Inoshita, M.D.
• Emleigh Elaine Inskeep, CDCA
• Integrity Homes of Scioto County, Inc
• Invested Therapeutics PLLC

• Family Nurse Practitioner in Portsmouth, OH
• Providers in Portsmouth, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; 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.