Individual provider Active NPI

Steven Jay Ossakow, MD FACS

  • Otolaryngology Physician
  • Canton, OH
National Provider Identifier
1225050248
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
35055075 Issued in OH
Practice address
4912 Higbee Avenue NW
Suite 200
Canton, OH 44718
Phone
(330) 492-2844
Fax
(330) 492-0840
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 35055075 OH Primary

Addresses

Primary practice location

4912 Higbee Avenue NW
Suite 200
Canton, OH 44718

Mailing address

4912 Higbee Avenue NW
Suite 200
Canton, OH 44718
Phone (330) 492-2844

Other identifiers 1

IdentifierTypeStateIssuer
0665838MedicaidOH

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
I20100726000018 OH Practitioner - Otolaryngology 9537067012 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35055075OHMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Head and Neck Surgeons, Inc Otolaryngology CurrentSince Oct 1, 1985 Accepting new patients
Shared Pet Imaging LLC PastSince Nov 1, 2007 Accepting new patients

Locations

4912 Higbee Ave NW
Ste 200
Canton, OH 44718
Phone (330) 492-2844

4912 Higbee Ave NW
Canton, OH 44718
Phone (330) 492-0685

340 Oxford St
Ste 310
Dover, OH 44622
Phone (330) 364-1618

6046 Whipple Ave NW
North Canton, OH 44720
Phone (330) 433-1200

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1225050248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4912 HIGBEE AVENUE NW",
            "address_2": "SUITE 200",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44718",
            "telephone_number": "330-492-2844",
            "fax_number": "330-492-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4912 HIGBEE AVENUE NW",
            "address_2": "SUITE 200",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44718",
            "telephone_number": "330-492-2844",
            "fax_number": "330-492-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSSAKOW",
        "first_name": "STEVEN",
        "middle_name": "JAY",
        "credential": "MD FACS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "35055075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0665838",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.