NPIMap

Individual provider Active NPI

Gregory Paul Kezele, MD

  • Phlebology Physician
  • Beachwood, OH
National Provider Identifier
1972563997
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebology PhysicianTaxonomy code 202K00000X
License
35057308 Issued in OH
Practice address
3737 Park East Dr Ste 109
Beachwood, OH 44122-4329
Phone
(216) 464-7333
Fax
(216) 464-2696
NPI assigned
Mar 24, 2006
Last updated
Oct 30, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35-057308 OH
Phlebology Physician 202K00000X 35057308 OH Primary

Addresses

Primary practice location

3737 Park East Dr Ste 109
Beachwood, OH 44122-4329

Mailing address

3737 Park East Dr Ste 109
Beachwood, OH 44122-4329
Phone (216) 464-7333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040106000287 OH Practitioner - Family Practice 6204735582 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wright State University Boonshoft School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gregory P Kezele MD LLCGroup PAC ID 3072992130, 2 clinicians
Parker Skin and Aesthetic Clinic IncGroup PAC ID 4587614813, 10 clinicians

Practice addresses (Care Compare)

3600 Euclid Ave
Willoughby, OH 44094-4625
Phone (440) 413-0499

3737 Park E Dr
Suite 109
Beachwood, OH 44122-4329
Phone (216) 464-7333

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal54
Removal of tissue323
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35057308OHMDPhlebology Physician
35-057308OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gregory P Kezele MD LLC CurrentSince May 8, 2022 Accepting new patients
Parker Skin & Aesthetic Clinic Inc. CurrentSince Feb 1, 2018 Accepting new patients
Lake Hospital System, Inc Family Medicine CurrentSince Oct 17, 2012 Accepting new patients
Gregory P Kezele MD LLC CurrentSince May 16, 2022 Accepting new patients
Lake Hospital System Inc Family Medicine CurrentSince Oct 17, 2012 Accepting new patients
Lake Hospital System Inc. Past Accepting new patients
Lake Hospital System, Inc Family Medicine Past Accepting new patients
Lake Hospital System Past Accepting new patients
Erie Banks Emergency Physicians LLC Past Accepting new patients
Lake Hospital System Inc Past Accepting new patients
Lake Hospital System Inc. Family Medicine Past Accepting new patients
The Vein Center, LLP PastSince Aug 15, 2018 Accepting new patients

Locations

3737 Park East Dr
Ste 109
Beachwood, OH 44122
Phone (216) 464-7333

510 5th Ave
Chardon, OH 44024
Phone (440) 285-9494

6270 N Ridge Rd
Madison, OH 44057
Phone (440) 428-8292

7956 Tyler Blvd
Mentor on Lk, OH 44060
Phone (440) 255-4455

10780 Kinsman Rd
Newbury, OH 44065
Phone (440) 564-5656

2001 Crocker Rd
Ste 150
Westlake, OH 44145
Phone (440) 235-8484

36000 Euclid Ave
Willoughby Hills, OH 44094
Phone (440) 375-8166

29804 Lake Shore Blvd
Willowick, OH 44095
Phone (440) 585-3322

30498 Lake Shore Blvd
Willowick, OH 44095
Phone (440) 585-3322

Interoperability endpoints

  • Direct secure messaging: gkezele219129@ehrdirect.uhhospitals.org

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1972563997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 PARK EAST DR STE 109",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224329",
            "telephone_number": "216-464-7333",
            "fax_number": "216-342-5462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 PARK EAST DR STE 109",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224329",
            "telephone_number": "216-464-7333",
            "fax_number": "216-464-2696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEZELE",
        "first_name": "GREGORY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-057308",
            "primary": false
        },
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "OH",
            "license": "35057308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.