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DR. TEOFILO GOZAINE MD
NPI 1598764102
Otolaryngology in Charleston, WV

Active since July 15, 2005PECOS EnrolledAccepts Medicare Assignment
59.83/100
CMS Quality Rating
830 PENNSYLVANIA AVE STE 204, CHARLESTON, WV 25302(304) 388-2980 Get Directions Write a Review

NPPES record last updated: February 10, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 19, 2025, Jun 4, 2025 (2 updates tracked since 2025).

About Dr. Teofilo Gozaine Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. TEOFILO GOZAINE MD (NPI 1598764102) is an individual otolaryngology provider in Charleston, West Virginia, licensed in West Virginia (35888) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, is affiliated with Essentia Health St Mary's Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1598764102
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameDR. TEOFILO GOZAINECredential: MD
Location Address830 PENNSYLVANIA AVE STE 204Charleston, WV 25302-3389
Mailing Address506 S 6th StLeesville, LA 71446-4482 · (337) 239-2234 · Fax (337) 239-2238
Phone(304) 388-2980
Sole ProprietorNo
Medical School CMSOtherGraduated 1999
Enumeration DateJuly 15, 2005
Last NPPES UpdateFebruary 10, 20262 updates tracked since enumeration
NPPES CertifiedFebruary 10, 2026
✔ NPI 1598764102 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
Licenses✔ Licensed in WV · 35888✔ Licensed in LA · 15440R✔ Licensed in MN · 80003
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
830 PENNSYLVANIA AVE STE 204, Charleston, WV 25302
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1506 S 6th StLeesville, LA 71446-4442 · Phone (337) 239-2234
Location 2400 E 3rd StDuluth, MN 55805-1951 · Phone (218) 786-8364

Other Identifiers 2

Medicaid1461334LA
Medicaid1598764102WV

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CHRISTUS Health Plan, HMO Louisiana, Medica.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Teofilo Gozaine Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2668440306
PECOS Enrollment IDI20250627001526, I20260223003282
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
169 services107 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
99 services99 patients
Diagnostic exam of nasal passages using an endoscope 31231
A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.
38 services31 patients
Diagnostic exam of voice box using a flexible endoscope 31575
This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
30 services26 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
13 services12 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Essentia Health St Mary's Medical Center

Acute Care Hospitals · Duluth, MN
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240002
Location402 East Second StreetDuluth, MN 55805 · St. Louis County
Emergency services Birthing friendly

Essentia Health Duluth

Acute Care Hospitals · Duluth, MN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240019
Location502 East Second StreetDuluth, MN 55805 · St. Louis County
Birthing friendly

Charleston Area Medical Center

Acute Care Hospitals · Charleston, WV
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510022
Location501 Morris StreetCharleston, WV 25301 · Kanawha County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25302 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$124.46 typical visit price
range $53.20 – $164.59
Typical copayment $31.11 (range $13.30 – $41.14)
Most-billed visit code 99204
Established Patient
$66.84 typical visit price
range $16.47 – $133.29
Typical copayment $16.71 (range $4.11 – $33.32)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

59.83/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality29.93
Promoting Interoperability95
Improvement Activities20
Cost56.2

Reported Quality Measures

e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
100%165 patients5/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
4%263 patients1/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%290 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
16%432 patients1/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
72%432 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
1%432 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
10%432 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
2 suppliers11 claims11 services$22.26 avg. paid by Medicare
Tubing used with positive airway pressure device A7037
DME-Other DME · category DE001N
2 suppliers13 claims13 services$21.00 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
2 suppliers15 claims78 services$2.99 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
2 suppliers37 claims37 services$38.89 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. ANN WILLARD MS,CCCA
Audiologist
830 PENNSYLVANIA AVE STE 204
CHARLESTON, WV 25302
Kanawha County (304) 388-2980
DR. DINCHEN ANNA JARDINE M.D.
Otolaryngology
830 PENNSYLVANIA AVE STE 204
CHARLESTON, WV 25302
Kanawha County (304) 388-2980
JEFFREY JAMES SMYTHE PA-C
Physician Assistant
830 PENNSYLVANIA AVE STE 204
CHARLESTON, WV 25302
Kanawha County (304) 388-2980

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Teofilo Gozaine's NPI number?

The NPI number for Teofilo Gozaine is 1598764102. It was assigned to this individual provider in the NPPES registry on July 15, 2005.

Where is Teofilo Gozaine located?

Teofilo Gozaine practices at 830 Pennsylvania Ave Ste 204, Charleston, WV 25302. The listed phone number is (304) 388-2980.

What is Teofilo Gozaine's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Teofilo Gozaine enrolled in Medicare?

Yes. Teofilo Gozaine is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Teofilo Gozaine accept?

Health plans from CHRISTUS Health Plan, HMO Louisiana and Medica list Teofilo Gozaine as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Teofilo Gozaine affiliated with any hospitals?

According to CMS data, Teofilo Gozaine is affiliated with Essentia Health St Mary's Medical Center, Essentia Health Duluth and Charleston Area Medical Center.

When was this NPI record last updated?

The NPPES record for Teofilo Gozaine was last updated on February 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.