Jeffrey T Prem, M.D

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

35071936P Issued in OH

Practice address

6046 Whipple Ave NW Ste 203
North Canton, OH 44720-7616

Phone

(330) 588-8900

Fax

(330) 588-8990

NPI assigned

Nov 10, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

General SurgeryAlso: Vascular Surgery

Education

Wright State University Boonshoft School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cleveland Clinic Mercy Hospital 92 clinicians

Aultman Hospital 41 clinicians

Regional Vascular and Vein Institute Inc 4 clinicians

The Union Hospital Association 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aultman Hospital Hospital, Canton, OH, CCN 360084
• Mercy Medical Center Hospital, Canton, OH, CCN 360070
• Union Hospital Hospital, Dover, OH, CCN 360010
• Aultman Orrville Hospital Hospital, Orrville, OH, CCN 361323
• Alliance Community Hospital Hospital, Alliance, OH, CCN 360131

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Aultman Hospital

  • Specialist
  • Canton, OH
  • NPI 1619911054

  OH

  Medicare reassignment Care Compare group NPD
• Cleveland Clinic Mercy Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1366433195

  OH

  Medicare reassignment Care Compare group NPD
• The Union Hospital Association

  • Rural Acute Care Hospital
  • Dover, OH
  • NPI 1871606921

  OH

  Medicare reassignment Care Compare group NPD
• Regional Vascular & Vein Institute Inc

  • Vascular Surgery Physician
  • North Canton, OH
  • NPI 1710938659

  OH

  Medicare reassignment Care Compare group
• Orrville Hospital Foundation

  • Critical Access Hospital
  • Orrville, OH
  • NPI 1891718375

  OH

  Medicare reassignment NPD
• Aultman Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1356366991
  Care Compare group NPD
• Aultman Hospital

  • Community/Retail Pharmacy
  • Canton, OH
  • NPI 1700941978
  Care Compare group NPD
• Regional Vascular & Vein Institute

  • Vascular Surgery Physician
  • North Canton, OH
  • NPI 1003094897

  Surgery

  NPD Authorized official
• The Union Hospital Association

  • Community/Retail Pharmacy
  • Dover, OH
  • NPI 1023316700
  Care Compare group NPD
• Aultman Hospital

  • Home Health Agency
  • Canton, OH
  • NPI 1669568564
  Care Compare group
• Aultman Hospital

  • Community Based Hospice Care Agency
  • Canton, OH
  • NPI 1700972601
  Care Compare group
• Aultman Hospital

  • Rehabilitation Hospital Unit
  • Canton, OH
  • NPI 1740222009
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Alliance Community Hospital

  • General Acute Care Hospital
  • Alliance, OH
  • NPI 1942385794

  Hospital

  Care Compare affiliation
• Aultman Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1356366991

  Hospital

  Care Compare affiliation
• Cleveland Clinic Mercy Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1366433195

  Hospital

  Care Compare affiliation
• Orrville Hospital Foundation

  • Critical Access Hospital
  • Orrville, OH
  • NPI 1891718375

  Hospital

  Care Compare affiliation
• The Union Hospital Association

  • Rural Acute Care Hospital
  • Dover, OH
  • NPI 1871606921

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1235110693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6046 WHIPPLE AVE NW STE 203",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207616",
            "telephone_number": "330-588-8900",
            "fax_number": "330-588-8990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6046 WHIPPLE AVE NW STE 203",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207616",
            "telephone_number": "330-588-8900",
            "fax_number": "330-588-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREM",
        "first_name": "JEFFREY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35071936P",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OH",
            "license": "35071936P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2048484",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Lizabeth Powers, MD
• Sheri L Poyer-Baker, COTA/L
• Kenneth J Pozun, MOTR/L
• Austin Prater, LPTA
• Julie M Pratt
• Premier Caregivers of Northern Ohio Inc.
• Heidi Dawn Presutti, COTA
• Philip Price, PH.D.
• Toshia Priest, LPTA
• Jonathan L Prijatel, PTA

• All providers in North Canton, OH
• Vascular Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.