Organization Active NPI

Northwest Ohio Gastroenterology Associates Inc.

  • Gastroenterology Physician
  • Toledo, OH
National Provider Identifier
1306945084
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
NORTHWEST OHIO GASTROENTEROLOGY ASSOCIATES INC.
Practice address
4841 Monroe St
Suite 110
Toledo, OH 43623-4385
Phone
(419) 471-1317
Fax
(419) 471-1316
NPI assigned
Sep 21, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. David ZackNPI 1407955008
Title
D.O.
Phone
(419) 471-1350

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X OH Primary

Addresses

Primary practice location

4841 Monroe St
Suite 110
Toledo, OH 43623-4385

Mailing address

4841 Monroe St
Suite 110
Toledo, OH 43623-4385
Phone (419) 471-1317

Other identifiers 2

IdentifierTypeStateIssuer
0125313MedicaidOH
CA4246OtherOHRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061214000078 OH Part B Supplier - Clinic/Group Practice 7517966872 Receives reassigned benefits from 8 practitioners
Practice locations: Toledo, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2043070Northwest Ohio Gastroenterology4841 Monroe Street, Suite 110, Toledo, OH 43623ComplianceJun 27, 2027

National Provider Directory

National Provider Directory

Locations

3404 W Sylvania Ave
Toledo, OH 43623
Phone (419) 407-1422

4841 Monroe St
Ste 1
Toledo, OH 43623

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HCDCBA

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1306945084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4841 MONROE ST",
            "address_2": "SUITE 110",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234385",
            "telephone_number": "419-471-1317",
            "fax_number": "419-471-1316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4841 MONROE ST",
            "address_2": "SUITE 110",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234385",
            "telephone_number": "419-471-1317",
            "fax_number": "419-471-1316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST OHIO GASTROENTEROLOGY ASSOCIATES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2022-07-21",
        "certification_date": "2021-09-28",
        "status": "A",
        "authorized_official_last_name": "ZACK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "D.O.",
        "authorized_official_telephone_number": "419-471-1350",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0125313",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA4246",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.