Individual provider Active NPI

Teressa J Patrick, MD

  • Gastroenterology Physician
  • Dayton, OH
National Provider Identifier
1992786222
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
35051929 Issued in OH
Practice address
1530 Needmore Rd Ste 101
Dayton, OH 45414-3900
Phone
(937) 534-7330
Fax
(937) 395-3682
NPI assigned
Nov 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 35051929 OH Primary

Addresses

Primary practice location

1530 Needmore Rd Ste 101
Dayton, OH 45414-3900

Mailing address

4340 Clyo Rd Ste 200
Dayton, OH 45459-7000
Phone (937) 396-2602

Other identifiers 1

IdentifierTypeStateIssuer
0590301MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address digestivespecialists@directaddress.net Health Information Exchange (HIE)

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
I20040525001123 OH Practitioner - Gastroenterology 1355239104 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Ohio State University College of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Health Specialists IncGroup PAC ID 5597708594, 576 clinicians
Digestive Specialists IncGroup PAC ID 2062300809, 25 clinicians

Practice addresses (Care Compare)

1 Wyoming St
Dayton, OH 45409-2722
Phone (937) 208-8000

4340 Clyo Rd
Dayton, OH 45459-7000
Phone (937) 396-2602

5697 Shull Rd
Suite 200
Huber Heights, OH 45424-1203
Phone (937) 534-7330

77 W Eleanor Dr
Springboro, OH 45066-1615
Phone (937) 534-7330

Hospital & facility affiliations

  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051
  • Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
  • Kettering Health Troy Hospital, Troy, OH, CCN 360368
  • Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079

Merit-based Incentive Payment System (MIPS)

Final score
95.84 of 100Reported as group
Quality
92.44
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy35
Upper gastrointestinal (GI) endoscopy for acid reflux36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35051929OHMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc CurrentSince Mar 23, 2026 Accepting new patients
Digestive Specialists Inc Gastroenterology CurrentSince Apr 1, 1997 Accepting new patients
Premier Health Specialists Inc CurrentSince Mar 23, 2026 Accepting new patients
Premier Heart Associates, Inc Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Digestive Specialists Inc Gastroenterology Past Accepting new patients

Locations

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

4340 Clyo Rd
#200
Dayton, OH 45459
Phone (937) 396-2602

5697 Shull Rd
#200
Huber Heights, OH 45424
Phone 93729344245154

360 W Central Ave
Springboro, OH 45066
Phone (937) 208-7100

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

55 Elva Ct
#100
Vandalia, OH 45377
Phone (937) 208-7508

Organizations & group practices 8

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": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1992786222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4340 CLYO RD STE 200",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454597000",
            "telephone_number": "937-396-2602",
            "fax_number": "937-395-3682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 NEEDMORE RD STE 101",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454143900",
            "telephone_number": "937-534-7330",
            "fax_number": "937-395-3682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "TERESSA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-14",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "35051929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0590301",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "digestivespecialists@directaddress.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4340 Clyo Rd Ste 200",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454597000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.