Individual provider Active NPI

Lorie D Gottwald, M.D.

  • Dermatology Physician
  • Toledo, OH
National Provider Identifier
1720072275
Registry record updated Dec 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
35070505 Issued in OH
Practice address
3125 Transverse Dr
Toledo, OH 43614-8008
Phone
(419) 383-3780
Fax
(419) 383-2956
NPI assigned
Sep 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 35070505 OH Primary

Addresses

Primary practice location

3125 Transverse Dr
Toledo, OH 43614-8008

Mailing address

3355 Glendale Ave FL 3
Toledo, OH 43614-2426
Phone (419) 383-3780

Other practice location 1

3120 Glendale Ave
Toledo
Toledo, OH 43614-5811
Phone (419) 383-3781

Other identifiers 1

IdentifierTypeStateIssuer
0314850MedicaidOH

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
I20040227000955 OH Practitioner - DermatologyPractitioner - Internal Medicine 6406743111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Internal Medicine
Education
University of Toledo College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Toledo Physicians LLCGroup PAC ID 8729983416, 400 clinicians

Practice addresses (Care Compare)

3125 Transverse Dr
Toledo, OH 43614-8008
Phone (419) 383-5000

3333 Glendale Ave
Toledo, OH 43614-2426
Phone (419) 383-5550

3355 Glendale Ave
Toledo, OH 43614-2426
Phone (419) 383-5614

Hospital & facility affiliations

  • University of Toledo Medical Center Hospital, Toledo, OH, CCN 360048
  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068
  • Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112

Merit-based Incentive Payment System (MIPS)

Final score
88.34 of 100Reported as group
Quality
69.17
Promoting interoperability
99
Improvement activities
40
Cost
75

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions250
Skin biopsy49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35070505OHMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical University of Ohio at Toledo Current Accepting new patients
University of Toledo Physicians LLC CurrentSince Aug 1, 1996 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

L4189
Columbus, OH 43260

3355 Glendale Ave
Toledo, OH 43614
Phone (419) 383-5614

3355 Glendale Ave
Fl 3
Toledo, OH 43614
Phone (419) 383-7100

3000 Arlington Ave
Toledo, OH 43614
Phone (419) 383-3556

3125 Transverse Dr
Toledo, OH 43614
Phone (419) 383-3771

Interoperability endpoints

  • Direct secure messaging: lgottwald25566@direct.utoledo.edu

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 4

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": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514419200000",
    "number": "1720072275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 GLENDALE AVE FL 3",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436142426",
            "telephone_number": "419-383-3780",
            "fax_number": "419-383-2956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 TRANSVERSE DR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436148008",
            "telephone_number": "419-383-3780",
            "fax_number": "419-383-2956"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3120 Glendale Ave",
            "address_2": "Toledo",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436145811",
            "country_code": "US",
            "telephone_number": "419-383-3781",
            "fax_number": "419-383-0354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOTTWALD",
        "first_name": "LORIE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-09",
        "last_updated": "2017-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35070505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0314850",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.