NPIMap

Individual provider Active NPI

Preetha Muthusamy, MD

  • Neuromuscular Medicine (Psychiatry & Neurology) Physician
  • Warren, OH
National Provider Identifier
1205001161
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromuscular Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084N0008X
License
35.091308 Issued in OH
Practice address
1932 Niles Cortland Rd NE
Warren, OH 44484-1055
Phone
(330) 306-6980
Fax
(330) 856-5887
NPI assigned
Apr 22, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 91308 OH
Neuromuscular Medicine (Psychiatry & Neurology) Physician 2084N0008X 35.091308 OH Primary

Addresses

Primary practice location

1932 Niles Cortland Rd NE
Warren, OH 44484-1055

Mailing address

1932 Niles Cortland Rd NE
Warren, OH 44484-1055
Phone (330) 306-6980

Other identifiers 1

IdentifierTypeStateIssuer
2949644MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090730000354 OH Practitioner - NeurologyPractitioner - Other (Physician) 0143373605 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ohio Physician Professional CorporationGroup PAC ID 2668406059, 143 clinicians

Practice addresses (Care Compare)

1932 Niles Cortland Rd NE
Warren, OH 44484-1055
Phone (330) 480-6547

2600 6TH St SW
Canton, OH 44710-1702
Phone (330) 454-8076

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.96 of 100Reported as group
Quality
77.5
Promoting interoperability
99
Improvement activities
40
Cost
74.58

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.091308OHMDNeuromuscular Medicine (Psychiatry & Neurology) Physician
91308OHMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
Ohio Physician Professional Corporation CurrentSince Jan 1, 2024 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Aug 27, 2023 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Aug 27, 2023 Accepting new patients

Locations

200 E State St
Alliance, OH 44601
Phone (330) 596-6000

2600 6th St SW
Ste A2710
Canton, OH 44710
Phone (330) 429-5656

2600 6th St SW
Canton, OH 44710
Phone (330) 363-2180

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

832 S Main St
Orrville, OH 44667
Phone (330) 456-2695

1932 Niles Cortland Rd NE
Warren, OH 44484
Phone (330) 306-5300

Interoperability endpoints

  • Direct secure messaging: pmuthusamy164527@direct.ccf.org

Organizations & group practices 4

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 7

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": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1205001161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1932 NILES CORTLAND RD NE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444841055",
            "telephone_number": "330-306-6980",
            "fax_number": "330-856-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1932 NILES CORTLAND RD NE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444841055",
            "telephone_number": "330-306-6980",
            "fax_number": "330-856-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTHUSAMY",
        "first_name": "PREETHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-22",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OH",
            "license": "91308",
            "primary": false
        },
        {
            "code": "2084N0008X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neuromuscular Medicine",
            "state": "OH",
            "license": "35.091308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2949644",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.