Individual provider Active NPI

Michael Kentris, D.O.

  • Neurology Physician
  • Youngstown, OH
National Provider Identifier
1063848240
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
34.013375 Issued in OH
Practice address
1044 Belmont Ave
Youngstown, OH 44504-1006
Phone
(330) 480-3285
Fax
(330) 480-2946
NPI assigned
Sep 19, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 34.013375 OH Primary

Addresses

Primary practice location

1044 Belmont Ave
Youngstown, OH 44504-1006

Mailing address

1044 Belmont Ave
Youngstown, OH 44504-1006
Phone (330) 746-7211

Other practice location 1

9000 N Main St
Englewood, OH 45415-1180
Phone (937) 208-4200

Other practice location 2

2400 Miami Valley Dr
Centerville, OH 45459-4774
Phone (937) 208-4200

Other practice location 3

30 E Apple St Ste 5254A
Dayton, OH 45409-2939
Phone (937) 208-4200

Other practice location 4

1053 Belmont Ave
Youngstown, OH 44504-1007
Phone (330) 480-7350

Other identifiers 1

IdentifierTypeStateIssuer
0304184MedicaidOH

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180808003722 OH Practitioner - Neurology 6507085941 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1044 Belmont Ave
Youngstown, OH 44504-1006
Phone (330) 480-3655

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown LLC CurrentSince Mar 1, 2021 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown, LLC Neurology Current Accepting new patients
Premier Health Specialists Inc CurrentSince Aug 1, 2018 Accepting new patients
Premier Health Specialists Inc CurrentSince Aug 1, 2018 Accepting new patients

Locations

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

2400 Miami Valley Dr
Dayton, OH 45459
Phone (937) 208-8394

30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300

30 E Apple St
Ste 5254A
Dayton, OH 45409

9000 N Main St
Englewood, OH 45415
Phone (937) 208-8394

3170 Kettering Blvd
Bldg B2ND
Moraine, OH 45439

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

250 E Federal St
Fl 4
Youngstown, OH 44503
Phone (330) 884-7010

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

1053 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-3605

Interoperability endpoints

  • Direct secure messaging: mkentris847559@direct.bsmhealth.org

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 6

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": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1063848240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041006",
            "telephone_number": "330-746-7211",
            "fax_number": "330-746-7436"
        },
        {
            "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": "330-480-3285",
            "fax_number": "330-480-2946"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9000 N Main St",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "OH",
            "postal_code": "454151180",
            "country_code": "US",
            "telephone_number": "937-208-4200",
            "fax_number": "937-208-2678",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2400 Miami Valley Dr",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "OH",
            "postal_code": "454594774",
            "country_code": "US",
            "telephone_number": "937-208-4200",
            "fax_number": "937-208-2678",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30 E Apple St Ste 5254A",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454092939",
            "country_code": "US",
            "telephone_number": "937-208-4200",
            "fax_number": "937-208-4205",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1053 Belmont Ave",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445041007",
            "country_code": "US",
            "telephone_number": "330-480-7350",
            "fax_number": "330-746-7436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENTRIS",
        "first_name": "MICHAEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-19",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OH",
            "license": "34.013375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0304184",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.