Individual provider Active NPI

Elizabeth Ann Gegorski

  • Pediatrics Physician
  • Tiffin, OH
National Provider Identifier
1659908978
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35.147308 Issued in OH
Practice address
500 W Market St
Tiffin, OH 44883-2610
Phone
(419) 455-8150
Fax
(419) 455-8159
NPI assigned
Mar 25, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35.147308 OH Primary

Addresses

Primary practice location

500 W Market St
Tiffin, OH 44883-2610

Mailing address

500 W Market St
Tiffin, OH 44883-2610
Phone (419) 455-8150

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
I20230608000446 OH Practitioner - Pediatric Medicine 3577920453 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.147308OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Jul 31, 2023 Accepting new patients
Northwest Pediatric Specialists, LLC Pediatrics CurrentSince Jul 31, 2023 Accepting new patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Jul 31, 2023 Accepting new patients
Mercy Health - Tiffin Hospital LLC Past Accepting new patients

Locations

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

3521 Briarfield Blvd
Maumee, OH 43537
Phone (419) 794-7259

45 St Lawrence Dr
Tiffin, OH 44883
Phone (419) 448-1900

500 W Market St
Tiffin, OH 44883
Phone (419) 251-8210

3900 Sunforest Ct
Ste 240
Toledo, OH 43623
Phone (419) 472-3126

Interoperability endpoints

  • Direct secure messaging: egegorski850624@direct.bsmhealth.org
  • FHIR API: https://api.platform.athenahealth.com/2229/brand/3/csg/621/fhir/r4
  • FHIR API: https://hkc.nationwidechildrens.org/FHIR/MYCHART/api/FHIR/R4

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1659908978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W MARKET ST",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "448832610",
            "telephone_number": "419-455-8150",
            "fax_number": "419-455-8159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W MARKET ST",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "448832610",
            "telephone_number": "419-455-8150",
            "fax_number": "419-455-8159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEGORSKI",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.147308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tiffin, OH

Sources for this page

Verify at the official NPI Registry.