NPIMap

Individual provider Active NPI

Corey Richard Fazio, DO

  • Obstetrics & Gynecology Physician
  • Clyde, OH
National Provider Identifier
1285832279
Registry record updated Nov 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
34009034 Issued in OH
Practice address
1076 W McPherson Hwy
Clyde, OH 43410-1133
Phone
(419) 547-0216
Fax
(419) 547-9130
NPI assigned
Jul 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 34009034 OH Primary

Addresses

Primary practice location

1076 W McPherson Hwy
Clyde, OH 43410-1133

Mailing address

1400 W Main St
Building 1 Suite a
Bellevue, OH 44811-9088
Phone (419) 483-2494

Other identifiers 1

IdentifierTypeStateIssuer
2765315MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081113000230 OH Practitioner - Obstetrics/Gynecology 6507926094 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Ohio University, College of Osteopathic Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Ohio Medical Specialists,LLC 252 clinicians

Practice addresses (Care Compare)

521 N Sandusky St
Bellevue, OH 44811-1180
Phone (419) 483-6267

Hospital & facility affiliations

  • Bellevue Hospital Hospital, Bellevue, OH, CCN 360107
  • Firelands Regional Medical Center Hospital, Sandusky, OH, CCN 360025
  • Memorial Hospital Hospital, Fremont, OH, CCN 360156

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34009034OHMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Ohio Medical Specialists, LLC CurrentSince Sep 19, 2022 Accepting new patients
Northern Ohio Medical Specialists LLC Obstetrics & Gynecology CurrentSince Sep 19, 2022 Accepting new patients
Fisher-Titus Medical Center Current Accepting new patients
Fisher-Titus Medical Care LLC CurrentSince Jun 1, 2018 Accepting new patients
Memorial Professional Services LTD Obstetrics & Gynecology Past Accepting new patients
Northern Ohio Medical Specialists, LLC Past Accepting new patients
The Bellevue Hospital Past Accepting new patients

Locations

521 N Sandusky St
Bellevue, OH 44811
Phone (419) 483-2190

1255 W Main St
Ste B
Bellevue, OH 44811
Phone (419) 334-3869

272 Benedict Ave
Norwalk, OH 44857
Phone (419) 668-1341

3004 Hayes Ave
Sandusky, OH 44870
Phone (419) 625-2841

Interoperability endpoints

  • Direct secure messaging: coreyfazio@bpsoh.allscriptsdirect.net
  • Direct secure messaging: cfazio20248@nomshealthcare.direct-ci.com

Organizations & group practices 7

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227052800000",
    "number": "1285832279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 W MAIN ST",
            "address_2": "BUILDING 1 SUITE A",
            "city": "BELLEVUE",
            "state": "OH",
            "postal_code": "448119088",
            "telephone_number": "419-483-2494",
            "fax_number": "419-483-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1076 W MCPHERSON HWY",
            "city": "CLYDE",
            "state": "OH",
            "postal_code": "434101133",
            "telephone_number": "419-547-0216",
            "fax_number": "419-547-9130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZIO",
        "first_name": "COREY",
        "middle_name": "RICHARD",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-11",
        "last_updated": "2008-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "34009034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2765315",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clyde, OH

Sources for this page

Verify at the official NPI Registry.