EDWIN R ROZARIO M.D.
NPI 1780004093
Family Medicine in Wheeling, WV

Q: What is Edwin Rozario's NPI number?

The NPI number for Edwin Rozario is 1780004093. It was assigned to this individual provider in the NPPES registry on April 25, 2014.

Q: What is Edwin Rozario's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Edwin Rozario was last updated on June 4, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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 April 25, 2014PECOS EnrolledAccepts Medicare AssignmentCLIA 51D2205841 · Waiver

94.1/100

CMS Quality Rating

58 16TH STREET, WHEELING, WV 26003(304) 234-2122(304) 234-2006 Get Directions Write a Review

NPPES record last updated: June 4, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 4, 2020, Feb 9, 2016 (2 updates tracked since 2016).

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About Edwin R Rozario M.d. NPPES

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

EDWIN R ROZARIO M.D. (NPI 1780004093) is an individual family medicine provider in Wheeling, West Virginia, licensed in West Virginia (29482) and active in the NPI registry since April 2014. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through December 15, 2026, and is affiliated with Barnesville Hospital Association, Inc.

NPPES Registry Identity

NPI1780004093

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameEDWIN R ROZARIOCredential: M.D.

Location Address58 16TH STREETWheeling, WV 26003

Mailing Address58 16th StreetWheeling, WV 26003 · (304) 234-2122 · Fax (304) 234-2006

Phone(304) 234-2122

Fax(304) 234-2006

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateApril 25, 2014

Last NPPES UpdateJune 4, 20202 updates tracked since enumeration

NPPES CertifiedJune 4, 2020

✔ NPI 1780004093 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in WV · 29482

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

58 16TH STREET, Wheeling, WV 26003

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Other Identifiers 1

Medicaid0389613OH

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

Edwin R Rozario 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 ID1355569773

PECOS Enrollment IDI20200306002100

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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 51D2205841

Edwin Rozario MD / Wheeling Hospital · Wheeling, WV

Active · expires Dec 15, 2026

CLIA Number51D2205841

Laboratory TypePhysician Office

Certificate Effective DateDecember 16, 2024

Certificate Expiration DateDecember 15, 2026

Laboratory DirectorDr. Edwin Rozario

Laboratory Phone(304) 243-3848

Laboratory LocationEdwin Rozario MD / Wheeling HospitalWheeling Clinic 58 16th Street, Wheeling, WV 26003

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

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 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.

372 services206 patients

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.

234 services129 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

154 services154 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

19 services14 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

12 services12 patients

Hospital Affiliations CMS Care Compare 3

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

Barnesville Hospital Association, Inc

Critical Access Hospitals · Barnesville, OH

OwnershipVoluntary non-profit - Private

CMS Certification Number361321

Location639 West Main StreetBarnesville, OH 43713 · Belmont County

Emergency services

Reynolds Memorial Hospital

Acute Care Hospitals · Glen Dale, WV

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number510013

Location800 Wheeling AveGlen Dale, WV 26038 · Marshall County

Emergency services Birthing friendly

Wheeling Hospital, Inc

Acute Care Hospitals · Wheeling, WV

1/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number510050

Location1 Medical ParkWheeling, WV 26003 · Ohio County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 26003 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

$83.49 typical visit price

range $53.20 – $164.59

Typical copayment $20.87 (range $13.30 – $41.14)

Most-billed visit code 99203

Established Patient

$94.81 typical visit price

range $16.47 – $133.29

Typical copayment $23.70 (range $4.11 – $33.32)

Most-billed visit code 99214

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.

94.1/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

78.46

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 6

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

11 suppliers38 claims105 services$6.32 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

9 suppliers22 claims26 services$1.12 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier12 claims12 services$16.15 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers29 claims32 services$80.16 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

1 supplier18 claims4,875 services$0.03 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

2 suppliers27 claims27 services$25.07 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 11

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

MRS. AMANDA PATRICIA WAKIM MSN,FNP-BC

Nurse Practitioner (Primary Care)