Theodore Marino Ezekiel Gagianas, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

50.007297 Issued in OH

Practice address

1995 E State St
Salem, OH 44460-2423

Phone

(330) 332-7840

Fax

(330) 332-7847

NPI assigned

Dec 29, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SCH Professional CorporationGroup PAC ID 0941291868, 59 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Salem Regional Medical Center Hospital, Salem, OH, CCN 360185

Merit-based Incentive Payment System (MIPS)

Final score

84.84 of 100Reported as apm

Quality

69.69

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• SCH Professional Corporation

  • Family Medicine Physician
  • Salem, OH
  • NPI 1619959822
  Medicare reassignment Care Compare group
• Windber Hospital, Inc.

  • General Acute Care Hospital
  • Windber, PA
  • NPI 1275620536
  NPD (past)

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

• Salem Community Hospital

  • General Acute Care Hospital
  • Salem, OH
  • NPI 1639131535
  Care Compare affiliation
• Salem Community Hospital

  • Radiology Clinic/Center
  • Calcutta, OH
  • NPI 1750227377

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1451347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1396100749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1995 E STATE ST",
            "city": "SALEM",
            "state": "OH",
            "postal_code": "444602423",
            "telephone_number": "330-332-7840",
            "fax_number": "330-332-7847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 E STATE ST",
            "city": "SALEM",
            "state": "OH",
            "postal_code": "444602423",
            "telephone_number": "330-332-7840",
            "fax_number": "330-332-7847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGIANAS",
        "first_name": "THEODORE",
        "middle_name": "MARINO EZEKIEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-29",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA058003",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "OA003697",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50.007297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Theodore.Gagianas@salemregional.medicity.net",
            "affiliation": "N",
            "address_1": "1995 E State St",
            "city": "Salem",
            "state": "OH",
            "country_code": "US",
            "postal_code": "444602423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lauren Fredrickson, MD
• Lee Austin Fredrickson Jr., M.D.
• Frencor Inc
• James Ervin Friedl III, DO
• Erin Fuschetto
• Gail C Herron Jr
• Erin Ruth Gallo, PT
• Abby L Galloway
• James Duane Gardner
• Tammy Garver, MS

• Surgical Physician Assistant in Salem, OH
• Providers in Salem, OH by specialty
• Surgical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.