Individual provider Active NPI

Cortney Ann Birchak

  • Family Nurse Practitioner
  • Boardman, OH
National Provider Identifier
1255994356
Registry record updated Apr 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.024541 Issued in OH
Practice address
7430 Southern Blvd
Boardman, OH 44512-5629
Phone
(330) 729-9214
NPI assigned
Apr 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.024541 OH Primary

Addresses

Primary practice location

7430 Southern Blvd
Boardman, OH 44512-5629

Mailing address

2490 NE River Rd
Lake Milton, OH 44429-9780
Phone (330) 770-9350

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190502000727 OH Practitioner - Nurse Practitioner 8921340472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neo Urology Associates IncGroup PAC ID 8628088036, 18 clinicians

Practice addresses (Care Compare)

7430 Southern Blvd
Boardman, OH 44512-5629
Phone (330) 729-9214

Hospital & facility affiliations

  • MH St Elizabeth Youngstown Hospital Hospital, Youngstown, OH, CCN 360064
  • MH St Joseph Warren Hospital Hospital, Warren, OH, CCN 360161
  • HMHP St Elizabeth Boardman Health Center Hospital, Boardman, OH, CCN 360276

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.024541OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neo Urology Associates Inc CurrentSince May 1, 2019 Accepting new patients
Dermatology Associates of Youngstown Inc PastSince May 1, 2019 Accepting new patients

Locations

6262 Mahoning Ave
Ste C
Youngstown, OH 44515
Phone 3307299214225

7430 Southern Blvd
Youngstown, OH 44512
Phone (330) 729-9214

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1255994356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2490 NE RIVER RD",
            "city": "LAKE MILTON",
            "state": "OH",
            "postal_code": "444299780",
            "telephone_number": "330-770-9350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7430 SOUTHERN BLVD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445125629",
            "telephone_number": "330-729-9214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRCHAK",
        "first_name": "CORTNEY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-15",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.024541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

Verify at the official NPI Registry.