NPIMap

Organization Active NPI

University Emergency Specialists LLC

  • Emergency Medicine Physician
  • Conneaut, OH
National Provider Identifier
1033454483
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
UNIVERSITY EMERGENCY SPECIALISTS LLC
Practice address
158 West Main Road
Conneaut, OH 44030-2039
Phone
(844) 474-4019
Fax
(440) 735-3775
NPI assigned
Dec 11, 2012
Last updated
Feb 24, 2023By the provider in NPPES
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
Amy Charley, ESQ
Title
Chief Legal Officer
Phone
(240) 686-2300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

158 West Main Road
Conneaut, OH 44030-2039

Mailing address

12420 Milestone Center Dr Ste 200
Germantown, MD 20876-7111
Phone (240) 686-2300

Other names 1

  • Alteon Health Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130905000711 OH Part B Supplier - Clinic/Group Practice 4587807854 Receives reassigned benefits from 41 practitioners
Practice locations: Conneaut, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 43

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1355184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677196800000",
    "number": "1033454483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12420 MILESTONE CENTER DR STE 200",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208767111",
            "telephone_number": "240-686-2300",
            "fax_number": "240-686-2329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 WEST MAIN ROAD",
            "city": "CONNEAUT",
            "state": "OH",
            "postal_code": "440302039",
            "telephone_number": "844-474-4019",
            "fax_number": "440-735-3775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY EMERGENCY SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-11",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A",
        "authorized_official_last_name": "CHARLEY",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CHIEF LEGAL OFFICER",
        "authorized_official_telephone_number": "240-686-2300",
        "authorized_official_credential": "ESQ"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alteon Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Conneaut, 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.