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

Last updated

Apr 9, 2020By the provider in NPPES

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

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 HospitalGroup PAC ID 0547156796, 92 clinicians

Aultman HospitalGroup PAC ID 3779485867, 41 clinicians

Regional Vascular and Vein Institute IncGroup PAC ID 6002704541, 4 clinicians

The Union Hospital AssociationGroup PAC ID 0648177725, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aultman Hospital

  • Specialist
  • Canton, OH
  • NPI 1619911054
  Medicare reassignment Care Compare group NPD
• Cleveland Clinic Mercy Hospital

  dba Mercy Medical Center

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1366433195
  Medicare reassignment Care Compare group NPD
• The Union Hospital Association

  dba Union Hospital

  • Rural Acute Care Hospital
  • Dover, OH
  • NPI 1871606921
  Medicare reassignment Care Compare group NPD
• Regional Vascular & Vein Institute Inc

  dba Regional Surgical Specialists, Inc

  • Vascular Surgery Physician
  • North Canton, OH
  • NPI 1710938659
  Medicare reassignment Care Compare group
• Orrville Hospital Foundation

  dba Aultman Orrville Hospital

  • Critical Access Hospital
  • Orrville, OH
  • NPI 1891718375
  Medicare reassignment NPD
• Regional Vascular & Vein Institute

  dba Regional Surgical Specialists, Inc

  • Vascular Surgery Physician
  • North Canton, OH
  • NPI 1003094897
  NPD Authorized official
• Aultman Hospital

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

  dba Aultman Employee Pharmacy

  • Community/Retail Pharmacy
  • Canton, OH
  • NPI 1700941978
  NPD
• Cleveland Clinic Mercy Hospital

  • Dental Clinic/Center
  • Canton, OH
  • NPI 1023362100
  NPD
• Community Pathologists Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Dover, OH
  • NPI 1467779397
  NPD
• Orrville Hospital Foundation

  dba Aultman Orrville Carrollton Schools Health Center

  • Rural Health Clinic/Center
  • Carrollton, OH
  • NPI 1902655681
  NPD
• RC Hastedt MD Inc

  • Anatomic Pathology Physician
  • Dover, OH
  • NPI 1235324104
  NPD

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
  Care Compare affiliation
• Aultman Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1356366991
  Care Compare affiliation
• Cleveland Clinic Mercy Hospital

  dba Mercy Medical Center

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1366433195
  Care Compare affiliation
• Orrville Hospital Foundation

  dba Aultman Orrville Hospital

  • Critical Access Hospital
  • Orrville, OH
  • NPI 1891718375
  Care Compare affiliation
• The Union Hospital Association

  dba Union Hospital

  • Rural Acute Care Hospital
  • Dover, OH
  • NPI 1871606921
  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": [],
    "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. (Heart & Home Health Care)
• Heidi Dawn Presutti, COTA
• Philip Price, PH.D.
• Toshia Priest, LPTA
• Jonathan L Prijatel, PTA

• Vascular Surgery Physician in North Canton, OH
• Providers in North Canton, OH by specialty
• 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.