Individual provider Active NPI

Caitlin Elizabeth Spillan, PA-C

  • Physician Assistant
  • Youngstown, OH
National Provider Identifier
1124423876
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50. 004179 Issued in OH
Practice address
4694 Belmont Ave
Youngstown, OH 44505-1012
Phone
(330) 480-7667
Fax
(330) 759-3851
NPI assigned
Oct 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 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. 004179 OH Primary

Addresses

Primary practice location

4694 Belmont Ave
Youngstown, OH 44505-1012

Mailing address

4694 Belmont Ave
Youngstown, OH 44505-1012
Phone (330) 480-7667

Other identifiers 1

IdentifierTypeStateIssuer
0130712MedicaidOH

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
I20150708003192 OH Practitioner - Physician Assistant 3870805526 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

107 Royal Birkdale Dr
Suite a
Columbiana, OH 44408-8493
Phone (330) 729-1934

410 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-8000

564 E 2ND St
Salem, OH 44460-2914
Phone (234) 567-8150

605 E Ohio Ave
Sebring, OH 44672-1643
Phone (330) 729-3125

9471 Market St
North Lima, OH 44452-8702

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50. 004179OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown, LLC Physician Assistant CurrentSince Aug 7, 2017 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients

Locations

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

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

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

4694 Belmont Ave
Youngstown, OH 44505
Phone (330) 480-7655

Interoperability endpoints

  • Direct secure messaging: cspillan337005@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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1124423876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4694 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445051012",
            "telephone_number": "330-480-7667",
            "fax_number": "330-759-3851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4694 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445051012",
            "telephone_number": "330-480-7667",
            "fax_number": "330-759-3851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPILLAN",
        "first_name": "CAITLIN",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-23",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50. 004179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0130712",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.