NPIMap

Individual provider Active NPI

Teofilo Gozaine, MD

  • Otolaryngology Physician
  • Charleston, WV
National Provider Identifier
1598764102
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
35888 Issued in WV
Practice address
830 Pennsylvania Ave Ste 204
Charleston, WV 25302-3389
Phone
(304) 388-2980
NPI assigned
Jul 15, 2005
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 35888 WV Primary
Otolaryngology Physician 207Y00000X 15440R LA
Otolaryngology Physician 207Y00000X 80003 MN

Addresses

Primary practice location

830 Pennsylvania Ave Ste 204
Charleston, WV 25302-3389

Mailing address

506 S 6TH St
Leesville, LA 71446-4482
Phone (337) 239-2234

Other practice location 1

400 E 3rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Other practice location 2

506 S 6th St
Leesville, LA 71446-4442
Phone (337) 239-2234

Other identifiers 2

IdentifierTypeStateIssuer
1598764102MedicaidWV
1461334MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, MN, WV3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20040921000728 LA Practitioner - Otolaryngology 2668440306 Reassigns benefits to 2 organizations
I20250627001526 MN Practitioner - Otolaryngology 2668440306 Reassigns benefits to 1 organization
I20260223003282 WV Practitioner - Otolaryngology 2668440306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

830 Pennsylvania Ave
Suite 204
Charleston, WV 25302-3389
Phone (304) 388-2901

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15440RLAMDOtolaryngology Physician
35888WVMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince Jan 19, 2026 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Jul 7, 2025 Accepting new patients
The Duluth Clinic, LTD CurrentSince Jul 7, 2025 Accepting new patients
Glen D. Hurlston, M.D., Apmc CurrentSince Apr 24, 2024 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Jan 19, 2026 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
GPN-Leesville, LLC Past Accepting new patients

Locations

1020 W Fertitta Blvd
Leesville, LA 71446
Phone (337) 239-5278

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

830 Pennsylvania Ave
Ste 204
Charleston, WV 25302
Phone (304) 388-2980

Interoperability endpoints

  • Direct secure messaging: brhtgozai@yourcarecommunity.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1598764102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 S 6TH ST",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464482",
            "telephone_number": "337-239-2234",
            "fax_number": "337-239-2238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 PENNSYLVANIA AVE STE 204",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253023389",
            "telephone_number": "304-388-2980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 E 3rd St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558051951",
            "country_code": "US",
            "telephone_number": "218-786-8364",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "506 S 6th St",
            "address_purpose": "LOCATION",
            "city": "Leesville",
            "state": "LA",
            "postal_code": "714464442",
            "country_code": "US",
            "telephone_number": "337-239-2234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOZAINE",
        "first_name": "TEOFILO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2026-09-29",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WV",
            "license": "35888",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "LA",
            "license": "15440R",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MN",
            "license": "80003",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598764102",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1461334",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.