Individual provider Active NPI

Jacob E Bieszczad, MD

  • Diagnostic Radiology Physician
  • Toledo, OH
National Provider Identifier
1417185240
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
121217 Issued in OH
Practice address
5757 Park Center CT.
Toledo, OH 43615
Phone
(419) 474-4064
Fax
(419) 472-2772
NPI assigned
Jul 1, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 121217 OH Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

5757 Park Center CT.
Toledo, OH 43615

Mailing address

5757 Park Center CT.
Toledo, OH 43615
Phone (419) 474-4064

Other identifiers 1

IdentifierTypeStateIssuer
0075653MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120810000836 MI Practitioner - Diagnostic Radiology 3476709122 Reassigns benefits to 1 organization
I20130720000273 OH Practitioner - Diagnostic Radiology 3476709122 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Radiology Services PCGroup PAC ID 4284546516, 252 clinicians
Toledo Radiological Associates IncGroup PAC ID 2567367519, 51 clinicians

Practice addresses (Care Compare)

109 Forest Gate Dr
Perrysburg, OH 43551-8868
Phone (616) 363-7272

1901 Bigelow St
Unit 416
Cincinnati, OH 45219-3815
Phone (616) 363-7272

718 N Macomb St
Monroe, MI 48162-7815
Phone (419) 474-4064

Hospital & facility affiliations

  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068
  • Wood County Hospital Hospital, Bowling Green, OH, CCN 360029
  • Promedica Monroe Regional Hospital Hospital, Monroe, MI, CCN 230099
  • Bay Park Community Hospital Hospital, Oregon, OH, CCN 360259
  • Promedica Charles and Virginia Hickman Hospital Hospital, Adrian, MI, CCN 230005

Merit-based Incentive Payment System (MIPS)

Final score
87.17 of 100Reported as group
Quality
90
Improvement activities
40
Cost
75.56

Merit-based Incentive Payment System (MIPS)

Final score
88.34 of 100Reported as group
Quality
69.17
Promoting interoperability
99
Improvement activities
40
Cost
75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
121217OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Illinois Radiological Associates, LTD. Diagnostic Radiology CurrentSince Feb 15, 2026 Accepting new patients
Medical University of Ohio at Toledo Current Accepting new patients
Advanced Radiology Services PC Diagnostic Radiology CurrentSince Mar 1, 2026 Accepting new patients
Cira Michigan PC Diagnostic Radiology CurrentSince Feb 15, 2026 Accepting new patients
Spartan Radiology, Inc Diagnostic Radiology PastSince Sep 1, 2024 Accepting new patients
Specialists in Medical Imaging, SC Diagnostic Radiology Past Accepting new patients

Locations

5200 Reliable Pkwy
Chicago, IL 60686
Phone (309) 671-8748

1870 Silver Cross Blvd
Ste 150
New Lenox, IL 60451
Phone (815) 300-1063

3000 Arlington Ave
Stop 1192
Toledo, OH 43614

3000 Arlington Ave
Toledo, OH 43614
Phone (419) 383-3556

Interoperability endpoints

  • Direct secure messaging: jbieszczad39332@direct.utoledo.edu

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": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1417185240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5757 PARK CENTER CT.",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43615",
            "telephone_number": "419-474-4064",
            "fax_number": "419-472-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 PARK CENTER CT.",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43615",
            "telephone_number": "419-474-4064",
            "fax_number": "419-472-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIESZCZAD",
        "first_name": "JACOB",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-01",
        "last_updated": "2023-03-07",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "121217",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0075653",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.