Organization Active NPI

Community Medical Associates, LTD.

  • Family Medicine Physician
  • Youngstown, OH
National Provider Identifier
1184761405
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COMMUNITY MEDICAL ASSOCIATES, LTD.
Practice address
1450 S Canfield Niles Rd
Youngstown, OH 44515
Phone
(330) 799-8752
Fax
(330) 799-8754
NPI assigned
Jan 30, 2007
Last updated
Apr 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Authorized official

Name
Daniel A. Miller, M.D.NPI 1255599171
Title
Owner/Practice Manager
Phone
(330) 799-8752

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OH Primary
Internal Medicine Physician 207R00000X OH

Addresses

Primary practice location

1450 S Canfield Niles Rd
Youngstown, OH 44515

Mailing address

1450 S Canfield Niles Rd
Youngstown, OH 44515
Phone (330) 799-8752

Other identifiers 2

IdentifierTypeStateIssuer
2588203MedicaidOH
000000179839OtherOHANTHEM GROUP NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040920000637 OH Part B Supplier - Clinic/Group Practice 3274501036 Receives reassigned benefits from 2 practitioners
Practice locations: Austintown, OH

National Provider Directory

National Provider Directory
Tax ID family
Community Medical Assoc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682640000000",
    "number": "1184761405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 S CANFIELD NILES RD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "44515",
            "telephone_number": "330-799-8752",
            "fax_number": "330-799-8754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 S CANFIELD NILES RD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "44515",
            "telephone_number": "330-799-8752",
            "fax_number": "330-799-8754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MEDICAL ASSOCIATES, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER/PRACTICE MANAGER",
        "authorized_official_telephone_number": "330-799-8752",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2588203",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM GROUP NUMBER",
            "identifier": "000000179839",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.