NPIMap

Organization Active NPI

Mahoning Valley Emergency Specialists LLC

  • Emergency Medicine Physician
  • Youngstown, OH
National Provider Identifier
1003869652
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
MAHONING VALLEY EMERGENCY SPECIALISTS LLC
Practice address
1044 Belmont Ave
Youngstown, OH 44504-1006
Phone
(844) 474-4019
NPI assigned
May 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Authorized official

Name
Mrs. Melissa Reese
Title
Provider Enrollment Officer
Phone
(855) 687-0618

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

1044 Belmont Ave
Youngstown, OH 44504-1006

Mailing address

4535 Dressler Rd NW
Canton, OH 44718-2545
Phone (330) 994-4409

Other identifiers 1

IdentifierTypeStateIssuer
000000028430OtherOHANTHEM

Other names 1

  • Mahoning Valley Emergency Specialists, Inc-Belmont Ave Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040609000114 OH Part B Supplier - Clinic/Group Practice 5698758993 Receives reassigned benefits from 154 practitioners
Practice locations: Youngstown, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 182

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 182

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677196800000",
    "number": "1003869652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182545",
            "telephone_number": "330-994-4409",
            "fax_number": "330-492-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041006",
            "telephone_number": "844-474-4019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHONING VALLEY EMERGENCY SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A",
        "authorized_official_last_name": "REESE",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT OFFICER",
        "authorized_official_telephone_number": "855-687-0618",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000028430",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mahoning Valley Emergency Specialists, Inc-Belmont Ave",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.