NPIMap

Individual provider Active NPI

Elizabeth Mary Sipusic, M.D.

  • Obstetrics & Gynecology Physician
  • Boardman, OH
National Provider Identifier
1033474002
Registry record updated May 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
35128623 Issued in OH
Practice address
22 McClurg Rd
Boardman, OH 44512-6736
Phone
(330) 965-9400
Fax
(330) 953-3330
NPI assigned
Jul 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology Physician 207V00000X 35128623 OH Primary

Addresses

Primary practice location

22 McClurg Rd
Boardman, OH 44512-6736

Mailing address

1001 Covington St
FL 2
Youngstown, OH 44510-1617
Phone (888) 696-3541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160920000312 OH Practitioner - Obstetrics/Gynecology 7315234341 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Northeastern Ohio University College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8401 Market St
Boardman, OH 44512-6725
Phone (330) 729-2929

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35128623OHMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown LLC CurrentSince Jun 10, 2019 Accepting new patients
Patrick J Skarote MD Inc Obstetrics & Gynecology CurrentSince Oct 3, 2016 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown, LLC Current Accepting new patients

Locations

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

2031 Belmont Ave
Ste B
Youngstown, OH 44505
Phone (330) 480-3033

1001 Covington St
Fl 2
Youngstown, OH 44510
Phone (330) 480-3033

1001 Covington St
Youngstown, OH 44510
Phone (330) 480-2616

22 McClurg Rd
Youngstown, OH 44512
Phone (330) 965-9400

8401 Market St
Youngstown, OH 44512
Phone (330) 729-2929

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

Interoperability endpoints

  • Direct secure messaging: esipusic237218@direct.bsmhealth.org

Organizations & group practices 5

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 3

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": "1341446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558483200000",
    "number": "1033474002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 COVINGTON ST",
            "address_2": "FL 2",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445101617",
            "telephone_number": "888-696-3541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 MCCLURG RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445126736",
            "telephone_number": "330-965-9400",
            "fax_number": "330-953-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIPUSIC",
        "first_name": "ELIZABETH",
        "middle_name": "MARY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-05",
        "last_updated": "2019-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "35128623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

Verify at the official NPI Registry.