Individual provider Active NPI

Alicia Lynn Agati

  • Family Nurse Practitioner
  • Youngstown, OH
National Provider Identifier
1083495451
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0034550 Issued in OH
Practice address
1Trussel Way
Youngstown, OH 44555-0001
Phone
(330) 941-3000
NPI assigned
Oct 11, 2023
Last updated
Oct 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.454762 OH
Family Nurse Practitioner 363LF0000X APRN.CNP.0034550 OH Primary

Addresses

Primary practice location

1Trussel Way
Youngstown, OH 44555-0001

Mailing address

8027 Raglan Dr NE
Warren, OH 44484-7400
Phone (330) 974-6753

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
I20240117004223 OH Practitioner - Nurse Practitioner 5890147631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ashtabula County Medical CenterGroup PAC ID 2668465600, 70 clinicians

Practice addresses (Care Compare)

8220 State Route 45
Orwell, OH 44076-9701
Phone (440) 437-3300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.454762OHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Ashtabula County Medical Center CurrentSince Jan 5, 2024 Accepting new patients

Locations

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

8220 State Route 45
Orwell, OH 44076

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1696982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1083495451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8027 RAGLAN DR NE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444847400",
            "telephone_number": "330-974-6753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1TRUSSEL WAY",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445550001",
            "telephone_number": "330-941-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGATI",
        "first_name": "ALICIA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-11",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.454762",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0034550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.