Individual provider Active NPI

Thomas Donald Macabobby, M.D.

  • Family Medicine Physician
  • Boardman, OH
National Provider Identifier
1104820059
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-085267 Issued in OH
Practice address
8423 Market St
Ste 101
Boardman, OH 44512-6778
Phone
(330) 729-8700
Fax
(330) 729-8701
NPI assigned
Jun 9, 2005
Last updated
Oct 31, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35-085267 OH Primary

Addresses

Primary practice location

8423 Market St
Ste 101
Boardman, OH 44512-6778

Mailing address

8423 Market St
Ste 101
Boardman, OH 44512-6778
Phone (330) 729-8700

Other identifiers 2

IdentifierTypeStateIssuer
2551886MedicaidOH
H143780OtherOHMEDICARE PTAN

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
I20050504000235 OH Practitioner - Family Practice 1759321235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Northeastern Ohio University College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Youngstown, LLCGroup PAC ID 9234318270, 116 clinicians

Practice addresses (Care Compare)

8423 Market St
Suite 205
Boardman, OH 44512-6778
Phone (330) 729-3125

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-085267OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown LLC CurrentSince Dec 16, 2012 Accepting new patients
Mercy Health Physicians Youngstown, LLC Family Medicine Current Accepting new patients
Mercy Health Youngstown LLC Past Accepting new patients

Locations

107 Royal Birkdale Dr
Columbiana, OH 44408
Phone (330) 332-5232

9471 Market St
Ste B
North Lima, OH 44452
Phone (330) 480-0937

564 E 2nd St
Salem, OH 44460
Phone (234) 567-8150

8423 Market St
Youngstown, OH 44512
Phone (330) 793-7966

8423 Market St
Ste 205
Youngstown, OH 44512
Phone (330) 729-1937

8423 Market St
Ste 101
Youngstown, OH 44512
Phone (330) 729-8700

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

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

Interoperability endpoints

  • Direct secure messaging: tmacabobby16879@direct.bsmhealth.org

Organizations & group practices 3

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1104820059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8423 MARKET ST",
            "address_2": "STE 101",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445126778",
            "telephone_number": "330-729-8700",
            "fax_number": "330-729-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8423 MARKET ST",
            "address_2": "STE 101",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445126778",
            "telephone_number": "330-729-8700",
            "fax_number": "330-729-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACABOBBY",
        "first_name": "THOMAS",
        "middle_name": "DONALD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-085267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2551886",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "H143780",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

Verify at the official NPI Registry.