DR. HOSSEIN K ELGAFY M.D.
NPI 1629087168
Orthopaedic Surgery in Toledo, OH

Q: What is Hossein Elgafy's NPI number?

The NPI number for Hossein Elgafy is 1629087168. It was assigned to this individual provider in the NPPES registry on August 5, 2006.

Q: What is Hossein Elgafy's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Hossein Elgafy was last updated on January 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since August 05, 2006PECOS EnrolledAccepts Medicare Assignment

1125 HOSPITAL DR FL 1, TOLEDO, OH 43614(419) 383-3761(419) 383-2932 Get Directions Write a Review

NPPES record last updated: January 22, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 22, 2026, Mar 15, 2018, Aug 25, 2017 and 2 more (5 updates tracked since 2016).

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About Dr. Hossein K Elgafy M.d. NPPES

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

DR. HOSSEIN K ELGAFY M.D. (NPI 1629087168) is an individual orthopaedic surgery provider in Toledo, Ohio, licensed in Ohio (35088395) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Wood County Hospital, and is a graduate of Other (1985).

NPPES Registry Identity

NPI1629087168

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameDR. HOSSEIN K ELGAFYCredential: M.D.

Location Address1125 HOSPITAL DR FL 1Toledo, OH 43614-8001

Mailing Address3000 Arlington Ave Stop 1108Toledo, OH 43614-2595

Phone(419) 383-3761

Fax(419) 383-2932

Sole ProprietorNo

Medical School CMSOtherGraduated 1985

Enumeration DateAugust 5, 2006

Last NPPES UpdateJanuary 22, 20265 updates tracked since enumeration

NPPES CertifiedJanuary 22, 2026

✔ NPI 1629087168 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in OH · 35088395

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Also ListedOrthopaedic Surgery · Orthopaedic Surgery of the SpineTaxonomy 207XS0117X · License 35088395 (OH)

1125 HOSPITAL DR FL 1, Toledo, OH 43614

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Other Identifiers 1

Medicaid2685401OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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. Hossein K Elgafy M.d. 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 ID6406896703

PECOS Enrollment IDI20061012000582

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 11

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.

167 services105 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

67 services40 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.

46 services41 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

27 services25 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

23 services18 patients

Insertion of cage or mesh device to spine bone and disc space during spine fusion 22853

Spine fusion is a procedure to join two or more vertebrae. During this process, a cage or mesh device is inserted into the spine bone and disc space. This helps to stabilize the spine, reduce pain, and improve functionality. The device acts as a bridge for new bone to grow on.

16 services11 patients

Hospital Affiliations CMS Care Compare 5

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

Wood County Hospital

Acute Care Hospitals · Bowling Green, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360029

Location950 West Wooster StreetBowling Green, OH 43402 · Wood County

Emergency services Birthing friendly

University Of Toledo Medical Center

Acute Care Hospitals · Toledo, OH

3/5 CMS rating

OwnershipGovernment - State

CMS Certification Number360048

Location3000 Arlington AvenueToledo, OH 43699 · Lucas County

Emergency services

Fisher-Titus Hospital

Acute Care Hospitals · Norwalk, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360065

Location272 Benedict AvenueNorwalk, OH 44857 · Huron County

Emergency services Birthing friendly

Promedica Toledo Hospital

Acute Care Hospitals · Toledo, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360068

Location2142 North Cove BoulevardToledo, OH 43606 · Lucas County

Emergency services Birthing friendly

Memorial Hospital

Acute Care Hospitals · Fremont, OH

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number360156

Location715 South Taft AvenueFremont, OH 43420 · Sandusky County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43614 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

$84.72 typical visit price

range $54.34 – $166.65

Typical copayment $21.18 (range $13.58 – $41.66)

Most-billed visit code 99203

Established Patient

$68.07 typical visit price

range $17.10 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

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.

Reported Quality Measures

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

91%3,720 patients4/55-star benchmark: 100%

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%2,107 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…

55%796 patients3/55-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.

99%558 patients4/55-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.

76%1,801 patients4/55-star benchmark: 97%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

20%1,714 patients1/55-star benchmark: 97%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 98% · 805 patients

Patients tobacco: 16% · 167 patients

72%805 patients3/55-star benchmark: 98%

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…

100%1,801 patients5/55-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…

20%1,801 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.

30%1,801 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.

Other Providers at the Same Location NPPES 8

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

GREGORY ALAN OTTO PA-C

Physician Assistant