Thomas Gerard Zaciewski, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

57.013762 Issued in OH

Practice address

27 St Lawrence Dr
Suite 204
Tiffin, OH 44883-8312

Phone

(419) 455-8570

Fax

(419) 455-8579

NPI assigned

Jul 30, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Urology

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Specialty Physicians of Blanchard Valley LLCGroup PAC ID 2668547613, 117 clinicians

Mercy Health Physicians North Specialty Care LLCGroup PAC ID 1951707884, 345 clinicians

Wyandot Memorial HospitalGroup PAC ID 1557340189, 70 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Health - Tiffin Hospital Hospital, Tiffin, OH, CCN 360089
• Wyandot Memorial Hospital Hospital, Upper Sandusky, OH, CCN 361329
• Mercy Health - Willard Hospital Hospital, Willard, OH, CCN 361310
• Blanchard Valley Hospital Hospital, Findlay, OH, CCN 360095

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tzaciewski27037@direct.bsmhealth.org

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.

• Mercy Health Physicians North Specialty Care LLC

  • Surgery Physician
  • Toledo, OH
  • NPI 1306468418

  Urology

  Medicare reassignment Care Compare group NPD
• Specialty Physicians of Blanchard Valley LLC

  • Cardiovascular Disease Physician
  • Findlay, OH
  • NPI 1689835415
  Medicare reassignment Care Compare group NPD
• Wyandot Memorial Hospital

  • Critical Access Hospital
  • Upper Sandusky, OH
  • NPI 1477554475
  Medicare reassignment Care Compare group NPD
• Intima Wellbeing, LLC

  • Nurse Practitioner
  • Findlay, OH
  • NPI 1164248191
  Medicare reassignment NPD
• Mercy Health Physicians-North LLC

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1609000769
  Medicare reassignment NPD
• Mercy Health Physicians - North, LLC

  dba Mercy Health - Perrysburg Podiatry

  • Customized Equipment (DME)
  • Perrysburg, OH
  • NPI 1992358766
  NPD
• Mercy Health Physicians North Specialty Care LLC

  • Customized Equipment (DME)
  • Toledo, OH
  • NPI 1235891672
  NPD
• Wyandot Memorial Hospital

  dba Wyandot Medical Providers at Carey

  • Rural Health Clinic/Center
  • Carey, OH
  • NPI 1659014728
  NPD
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

• Blanchard Valley Regional Health Center

  dba Blanchard Valley Hospital

  • General Acute Care Hospital
  • Findlay, OH
  • NPI 1710920327
  Care Compare affiliation
• Mercy Health - Tiffin Hospital LLC

  dba Harness Health Pharmacy

  • General Acute Care Hospital
  • Tiffin, OH
  • NPI 1316994734
  Care Compare affiliation
• Mercy Health - Willard Hospital LLC

  dba Mercy Health - Willard Hospital

  • Critical Access Hospital
  • Willard, OH
  • NPI 1790731016
  Care Compare affiliation
• Wyandot Memorial Hospital

  • Critical Access Hospital
  • Upper Sandusky, OH
  • NPI 1477554475
  Care Compare affiliation

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374624000000",
    "number": "1467618447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 ST LAWRENCE DR",
            "address_2": "SUITE 204",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "448838312",
            "telephone_number": "419-455-8570",
            "fax_number": "419-455-8579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 ST LAWRENCE DR",
            "address_2": "SUITE 204",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "448838312",
            "telephone_number": "419-455-8570",
            "fax_number": "419-455-8579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACIEWSKI",
        "first_name": "THOMAS",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-30",
        "last_updated": "2013-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "57.013762",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "35.121250",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Erin Young, H.I.S., A.B.O.C.
• Merris Young, MD
• Taylor Young
• Wade Earle Young, MD
• Samantha Renee Zaciewski, DDS
• Zellner Pharmacy Inc (Zellner Pharmacy)
• Kent Allen Zellner, RPH
• Noel' Carin Zimmerman, FNP-C

• Urology Physician in Tiffin, OH
• Providers in Tiffin, OH by specialty
• Urology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; 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.