Individual provider Active NPI

Kathryn Michele Jurenovich, DO

  • Orthopaedic Surgery of the Spine Physician
  • Boardman, OH
National Provider Identifier
1154781755
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
34.015932 Issued in OH
Practice address
7630 Southern Blvd
Boardman, OH 44512-5633
Phone
(330) 729-8000
NPI assigned
Feb 25, 2016
Last updated
Oct 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 39.015932 OH
Orthopaedic Surgery of the Spine Physician 207XS0117X 34.015932 OH Primary

Addresses

Primary practice location

7630 Southern Blvd
Boardman, OH 44512-5633

Mailing address

5385 Cloisters Dr
Canfield, OH 44406-8033
Phone (330) 540-6015

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
I20220823000833 OH Practitioner - Orthopedic Surgery 1254714314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novacare Rehabilitation of Ohio IncGroup PAC ID 0345159315, shared by 5 NPIs, 76 clinicians
Triad Health Services LLCGroup PAC ID 9032367917, 252 clinicians

Practice addresses (Care Compare)

656 Youngstown Warren Rd
Niles, OH 44446-4356
Phone (330) 505-1362

7629 Market St
Youngstown, OH 44512-6051

7630 Southern Blvd
Youngstown, OH 44512-5633
Phone (330) 729-8000

8740 E Market St
Suite 2
Warren, OH 44484-2324
Phone (330) 965-5090

9371 E Market St
Suite 2
Warren, OH 44484-5551
Phone (234) 287-6303

Hospital & facility affiliations

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
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
39.015932OHMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Triad Health Services, LLC CurrentSince Oct 1, 2022 Accepting new patients
Southwoods Health at Home, LLC PastSince Sep 1, 2021 Accepting new patients
The Surgery Center at Southwoods, LLC Past Accepting new patients

Locations

8740 E Market St
Ste 2
Warren, OH 44484
Phone (330) 647-6404

9371 E Market St
Ste 2
Warren, OH 44484
Phone (234) 287-6303

100 Debartolo Pl
Ste 200
Youngstown, OH 44512
Phone (330) 965-7828

250 Debartolo Pl
Ste C
Youngstown, OH 44512

7629 Market St
Ste 200
Youngstown, OH 44512
Phone (330) 729-8000

7629 Market St
Ste 250
Youngstown, OH 44512
Phone (330) 729-9480

7630 Southern Blvd
Youngstown, OH 44512
Phone (330) 729-8000

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 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": "1456358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1154781755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5385 CLOISTERS DR",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444068033",
            "telephone_number": "330-540-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7630 SOUTHERN BLVD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445125633",
            "telephone_number": "330-729-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURENOVICH",
        "first_name": "KATHRYN",
        "middle_name": "MICHELE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "OH",
            "license": "39.015932",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "OH",
            "license": "34.015932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

Verify at the official NPI Registry.