Organization Active NPI

Astute Medical Associates Inc

  • Internal Medicine Physician
  • Canton, OH
National Provider Identifier
1215984604
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ASTUTE MEDICAL ASSOCIATES INC
Practice address
2425 13TH St NW
Canton, OH 44708-3116
Phone
(330) 455-5595
Fax
(330) 455-5598
NPI assigned
May 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mike Crocker
Title
Secretary-Treasurer
Phone
(330) 455-5595

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2425 13TH St NW
Canton, OH 44708-3116

Mailing address

2425 13TH St NW
Canton, OH 44708-3116
Phone (330) 455-5595

Other identifiers 2

IdentifierTypeStateIssuer
0949326MedicaidOH
1120817OtherOHOHIO BWC NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050616000314 OH Part B Supplier - Clinic/Group Practice 2567406945 Receives reassigned benefits from 1 practitioner
Practice locations: Canton, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0882033Astute Medical Associates Inc2425 13TH Street NW, Canton, OH 44708Certificate of waiverJan 25, 2028

National Provider Directory

National Provider Directory

Locations

2425 13th St NW
Canton, OH 44708
Phone (330) 455-5595

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215984604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 13TH ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447083116",
            "telephone_number": "330-455-5595",
            "fax_number": "330-455-5598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 13TH ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447083116",
            "telephone_number": "330-455-5595",
            "fax_number": "330-455-5598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASTUTE MEDICAL ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CROCKER",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "SECRETARY-TREASURER",
        "authorized_official_telephone_number": "330-455-5595"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0949326",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO BWC NUMBER",
            "identifier": "1120817",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.