Individual provider Active NPI

Jason Sindledecker, NP-C

  • Adult Health Nurse Practitioner
  • Youngstown, OH
National Provider Identifier
1023406394
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
16123 Issued in OH
Practice address
1011 Boardman Canfield Rd
Youngstown, OH 44512-4226
Phone
(330) 629-2888
Fax
(330) 629-2946
NPI assigned
Jan 8, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 16123 OH
Adult Health Nurse Practitioner 363LA2200X 16123 OH Primary
Primary Care Nurse Practitioner 363LP2300X 16123 OH

Addresses

Primary practice location

1011 Boardman Canfield Rd
Youngstown, OH 44512-4226

Mailing address

1011 Boardman Canfield Rd
Youngstown, OH 44512-4226
Phone (330) 629-2888

Other identifiers 1

IdentifierTypeStateIssuer
0118087MedicaidOH

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150514001905 OH Practitioner - Nurse Practitioner 6204156219 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Partners Physician GroupGroup PAC ID 4183529340, 409 clinicians

Practice addresses (Care Compare)

2603 W Market St
Suite 200
Akron, OH 44313-4234
Phone (330) 677-3628

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
16123OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Recovery Center CurrentSince Jul 13, 2022 Accepting new patients
Partners Physician Group CurrentSince Jun 7, 2024 Accepting new patients
Partners Physician Group CurrentSince Jun 7, 2024 Accepting new patients
Partners Physician Group Past Accepting new patients
Family Recovery Center PastSince Jul 13, 2022 Accepting new patients

Locations

2603 W Market St
Ste 200
Akron, OH 44313
Phone (330) 854-1571

224 W Exchange St
Ste 160
Akron, OH 44302
Phone (330) 344-6505

307 W Main St
Ste C
Kent, OH 44240
Phone 3306773628219

964 N Market St
Lisbon, OH 44432
Phone (330) 424-1468

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Organizations & group practices 6

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 2

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": "1420675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437609600000",
    "number": "1023406394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 BOARDMAN CANFIELD RD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445124226",
            "telephone_number": "330-629-2888",
            "fax_number": "330-629-2946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 BOARDMAN CANFIELD RD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445124226",
            "telephone_number": "330-629-2888",
            "fax_number": "330-629-2946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINDLEDECKER",
        "first_name": "JASON",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-08",
        "last_updated": "2015-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "16123",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "16123",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "16123",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0118087",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.