Individual provider Active NPI

Theresa Sanderbeck-Barone, CNP

  • Adult Health Nurse Practitioner
  • Youngstown, OH
National Provider Identifier
1083669154
Registry record updated Sep 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
NP05924 Issued in OH
Practice address
925 Trailwood Dr
Youngstown, OH 44512-5008
Phone
(330) 758-7575
Fax
(330) 758-1833
NPI assigned
May 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X NP05924 OH Primary

Addresses

Primary practice location

925 Trailwood Dr
Youngstown, OH 44512-5008

Mailing address

925 Trailwood Dr
Youngstown, OH 44512-5008
Phone (330) 758-7575

Other identifiers 1

IdentifierTypeStateIssuer
2282220MedicaidOH

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
I20060822000497 OH Practitioner - Nurse Practitioner 5193728616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Triad Health Services LLCGroup PAC ID 9032367917, 252 clinicians

Practice addresses (Care Compare)

250 Debartolo PL
Youngstown, OH 44512-6026

7629 Market St
Youngstown, OH 44512-6051

Hospital & facility affiliations

  • Surgical Hospital at Southwoods Hospital, Youngstown, OH, CCN 360352
  • HMHP St Elizabeth Boardman Health Center Hospital, Boardman, OH, CCN 360276

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
71.12
Promoting interoperability
100
Improvement activities
40
Cost
75.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP05924OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Surgery Center at Southwoods, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tbarone@588b494e.micromddirect.com

Organizations & group practices 2

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 2

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284422400000",
    "number": "1083669154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 TRAILWOOD DR",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445125008",
            "telephone_number": "330-758-7575",
            "fax_number": "330-758-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 TRAILWOOD DR",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445125008",
            "telephone_number": "330-758-7575",
            "fax_number": "330-758-1833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERBECK-BARONE",
        "first_name": "THERESA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2010-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "NP05924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2282220",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.