Individual provider Active NPI

Teodora Tzvetanova Fatchikova, M.D.

  • Surgery Physician
  • Canton, OH
National Provider Identifier
1609309228
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35.146355 Issued in OH
Practice address
1320 Mercy Dr NW
Canton, OH 44708-2614
Phone
(330) 489-1000
NPI assigned
Apr 10, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OH
Surgery Physician 208600000X 35.146355 OH Primary

Addresses

Primary practice location

1320 Mercy Dr NW
Canton, OH 44708-2614

Mailing address

3212 Deborah CT
Uniontown, OH 44685-7571
Phone (616) 617-4832

Other practice location 1

1 Akron General Ave
Akron, OH 44307-2432
Phone (330) 344-6000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221011001405 OH Practitioner - General Surgery 6507139458 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Michigan State University College of Human Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Professional Care, LLCGroup PAC ID 7416857198, 53 clinicians
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

1330 Mercy Dr NW
Suite 418
Canton, OH 44708-2625
Phone (330) 489-1454

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 636-1768

Hospital & facility affiliations

  • Mercy Medical Center Hospital, Canton, OH, CCN 360070
  • Union Hospital Hospital, Dover, OH, CCN 360010

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.146355OHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Professional Care, LLC Surgery CurrentSince Oct 1, 2022 Accepting new patients
Cleveland Clinic Mercy Hospital Past Accepting new patients

Locations

1 Akron General Ave
Akron, OH 44307
Phone (330) 344-5760

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

1330 Mercy Dr NW
Ste 418
Canton, OH 44708
Phone (330) 489-1454

1330 Mercy Dr NW
Ste 319
Canton, OH 44708
Phone (330) 580-4706

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

Organizations & group practices 3

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 2

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": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1609309228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3212 DEBORAH CT",
            "city": "UNIONTOWN",
            "state": "OH",
            "postal_code": "446857571",
            "telephone_number": "616-617-4832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 MERCY DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082614",
            "telephone_number": "330-489-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Akron General Ave",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443072432",
            "country_code": "US",
            "telephone_number": "330-344-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FATCHIKOVA",
        "first_name": "TEODORA",
        "middle_name": "TZVETANOVA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-10",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35.146355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.