Individual provider Active NPI

Brandi Podboy

  • Physician Assistant
  • Tallmadge, OH
National Provider Identifier
1073101192
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.007622RX Issued in OH
Practice address
60 North Ave
Tallmadge, OH 44278-2011
Phone
(330) 630-9726
NPI assigned
Jan 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.007622RX OH Primary

Addresses

Primary practice location

60 North Ave
Tallmadge, OH 44278-2011

Mailing address

60 North Ave
Tallmadge, OH 44278-2011

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
I20220804001652 OH Practitioner - Physician Assistant 3678955861 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summa Physicians LLCGroup PAC ID 2961303532, 692 clinicians

Practice addresses (Care Compare)

525 E Market St
Akron, OH 44304-1619

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.007622RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Summa Physicians LLC CurrentSince Jul 5, 2022 Accepting new patients
Summa Physicians LLC CurrentSince Jul 5, 2022 Accepting new patients
Summa Physicians LLC Past Accepting new patients

Locations

525 E Market St
Akron, OH 44304
Phone (330) 375-6350

1077 Gorge Blvd
Akron, OH 44310
Phone (234) 312-5691

60 North Ave
Tallmadge, OH 44278
Phone (234) 867-7761

Interoperability endpoints

  • Direct secure messaging: bpodboy34377@summahealth-direct.org

Organizations & group practices 4

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 4

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": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1073101192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 NORTH AVE",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442782011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 NORTH AVE",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442782011",
            "telephone_number": "330-630-9726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODBOY",
        "first_name": "BRANDI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-05",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.007622RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallmadge, OH

Sources for this page

Verify at the official NPI Registry.