Thomas J Hagele

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

35.127460 Issued in OH

Practice address

1717 W Main St Ste 204
Newark, OH 43055-1362

Phone

(220) 564-7955

Fax

(220) 564-8956

NPI assigned

Apr 18, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Wright State University Boonshoft School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Licking Memorial Health ProfessionalsGroup PAC ID 6204740731, 235 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Licking Memorial Hospital Hospital, Newark, OH, CCN 360218

Merit-based Incentive Payment System (MIPS)

Final score

85.98 of 100Reported as group

Quality

75.66

Promoting interoperability

100

Improvement activities

40

Cost

75.38

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Licking Memorial Health Professionals

  • Family Medicine Physician
  • Newark, OH
  • NPI 1326072265
  Medicare reassignment Care Compare group NPD
• Licking Memorial Hospital

  • General Acute Care Hospital
  • Newark, OH
  • NPI 1568446755
  NPD
• Licking Memorial Professional Corporation

  • Durable Medical Equipment & Medical Supplies
  • Newark, OH
  • NPI 1326436510
  NPD
• Licking Memorial Hospital

  • Community/Retail Pharmacy
  • Newark, OH
  • NPI 1689458762
  NPD (past)
• Licking Memorial Professional Corp.

  • Surgery Physician
  • Newark, OH
  • NPI 1366461386
  NPD (past)

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

• Licking Memorial Hospital

  • General Acute Care Hospital
  • Newark, OH
  • NPI 1568446755
  Care Compare affiliation

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1659638443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 W MAIN ST STE 204",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551362",
            "telephone_number": "220-564-7955",
            "fax_number": "220-564-7956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 W MAIN ST STE 204",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551362",
            "telephone_number": "220-564-7955",
            "fax_number": "220-564-8956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGELE",
        "first_name": "THOMAS",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-18",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35.127460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thagele14352@lickingmemorial.medicity.net",
            "affiliation": "N",
            "address_1": "1717 W Main St Ste 204",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430551362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Debra Ann Gustafson, L.P.N.
• H2 Rehabilitation Services of Ohio LLC
• Lauren Cathryn Haas, MSW 1
• Mark Hacker, P.A.-C.
• Alexandra Marie Haffner, CNP
• Saad A. Hagras
• Virginia S Haines, LISW-S
• Courtney A Haley
• Jeanette Hall, QMHS
• Kaitlyn Hall

• Dermatology Physician in Newark, OH
• Providers in Newark, OH by specialty
• Dermatology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.