Individual provider Active NPI

Amy Marie Caicco, D.D.S.

  • General Practice Dentistry
  • Youngstown, OH
National Provider Identifier
1245685296
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.025002 Issued in OH
Practice address
1001 Covington St
Youngstown, OH 44510-1617
Phone
(330) 480-3195
Fax
(330) 480-1366
NPI assigned
Apr 27, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30.025002 OH Primary

Addresses

Primary practice location

1001 Covington St
Youngstown, OH 44510-1617

Mailing address

1001 Covington St
Youngstown, OH 44510-1617
Phone (330) 480-3195

Other identifiers 1

IdentifierTypeStateIssuer
0166984MedicaidOH

Other names 1

  • Amy Marie Nestor Former name

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171218001863 OH Practitioner - Dentist 9931499324 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio North East Health Systems Inc General Practice CurrentSince Jul 19, 2022 Accepting new patients
Mercy Health Physicians Youngstown LLC CurrentSince Jan 5, 2018 Accepting new patients
Mercy Health Physicians Youngstown, LLC CurrentSince Jan 5, 2018 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC Current Accepting new patients
Ohio North East Health Systems, Inc. General Practice CurrentSince Jul 19, 2022 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients

Locations

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

175 E Broad St
Newton Falls, OH 44444
Phone (330) 747-9551

1977 Niles Rd SE
Warren, OH 44484
Phone (330) 372-5800

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

1001 Covington St
Youngstown, OH 44510
Phone (330) 480-2616

726 Wick Ave
Youngstown, OH 44505
Phone (330) 747-2330

Interoperability endpoints

  • Direct secure messaging: acaicco345575@direct.bsmhealth.org
  • Direct secure messaging: amy.caicco.p1@direct.oho.nextgenshare.com

Organizations & group practices 7

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": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512691200000",
    "number": "1245685296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 COVINGTON ST",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445101617",
            "telephone_number": "330-480-3195",
            "fax_number": "330-480-1366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 COVINGTON ST",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445101617",
            "telephone_number": "330-480-3195",
            "fax_number": "330-480-1366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAICCO",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-27",
        "last_updated": "2017-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.025002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0166984",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "NESTOR",
            "middle_name": "MARIE",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.