Individual provider Active NPI

Brock Generalovich, D.O.

  • Plastic Surgery Physician
  • Youngstown, OH
National Provider Identifier
1861583528
Registry record updated Feb 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
34-008611 Issued in OH
Practice address
7641 Market St Ste 2
Youngstown, OH 44512-5980
Phone
(330) 726-3724
Fax
(330) 726-3725
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 34-008611 OH Primary

Addresses

Primary practice location

7641 Market St Ste 2
Youngstown, OH 44512-5980

Mailing address

7629 Market St Ste 200
Youngstown, OH 44512-6082
Phone (330) 965-4540

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
I20051108000282 OH Practitioner - Plastic and Reconstructive Surgery 0840218970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Philadelphia College of Osteopathic Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Triad Health Services LLCGroup PAC ID 9032367917, 252 clinicians

Practice addresses (Care Compare)

7645 Market St
Suite 210
Youngstown, OH 44512-6098
Phone (330) 726-3724

Hospital & facility affiliations

  • Surgical Hospital at Southwoods Hospital, Youngstown, OH, CCN 360352
  • HMHP St Elizabeth Boardman Health Center Hospital, Boardman, OH, CCN 360276
  • MH St Elizabeth Youngstown Hospital Hospital, Youngstown, OH, CCN 360064

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
71.12
Promoting interoperability
100
Improvement activities
40
Cost
75.36

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision50
Removal of tissue1-10
Removal or shaving of skin growth40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34-008611OHMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Triad Health Services, LLC Plastic Surgery CurrentSince Jan 1, 2014 Accepting new patients
The Surgery Center at Southwoods, LLC Past Accepting new patients
Mark a. Foglietti DO Inc Plastic Surgery PastSince May 9, 2018 Accepting new patients
Southwoods Health at Home, LLC PastSince Sep 1, 2021 Accepting new patients

Locations

7645 Market St
Ste 210
Youngstown, OH 44512
Phone (330) 726-3724

7629 Market St
Ste 250
Youngstown, OH 44512
Phone (330) 729-9480

7641 Market St
Ste 2
Youngstown, OH 44512
Phone (330) 726-0156

100 Debartolo Pl
Ste 200
Youngstown, OH 44512
Phone (330) 965-7828

7629 Market St
Ste 200
Youngstown, OH 44512
Phone (330) 729-8000

Interoperability endpoints

  • Direct secure messaging: bgeneralovich35249@direct.bsmhealth.org

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.

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423008000000",
    "number": "1861583528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7629 MARKET ST STE 200",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445126082",
            "telephone_number": "330-965-4540",
            "fax_number": "330-965-4559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7641 MARKET ST STE 2",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445125980",
            "telephone_number": "330-726-3724",
            "fax_number": "330-726-3725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENERALOVICH",
        "first_name": "BROCK",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2015-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "OH",
            "license": "34-008611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.