Individual provider Active NPI

Fernando G Chaves, MD

  • Pulmonary Disease Physician
  • Warren, OH
National Provider Identifier
1285613208
Registry record updated Oct 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
35053577 Issued in OH
Practice address
1421 E Market St
Warren, OH 44483-6609
Phone
(330) 393-5864
Fax
(330) 393-9921
NPI assigned
Jan 10, 2006
Last updated
Oct 29, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 35053577 OH Primary

Addresses

Primary practice location

1421 E Market St
Warren, OH 44483-6609

Mailing address

1421 E Market St
Warren, OH 44483-6609
Phone (330) 393-5864

Other identifiers 2

IdentifierTypeStateIssuer
0672928MedicaidOH
P00060248OtherOHRAILROAD MEDICARE

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
I20050817000172 OH Practitioner - Pulmonary Disease 5890725030

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
23.06 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
76.87

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35053577OHMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fernando G Chaves MD Inc Pulmonary Disease CurrentSince Oct 1, 1988 Accepting new patients
James David Koepsell MD SC Past Accepting new patients

Locations

1421 E Market St
Warren, OH 44483
Phone (330) 393-5864

1421 E Market St
Ste 103
Warren, OH 44483
Phone (216) 743-0589

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193616000000",
    "number": "1285613208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 E MARKET ST",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444836609",
            "telephone_number": "330-393-5864",
            "fax_number": "330-393-9921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 E MARKET ST",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444836609",
            "telephone_number": "330-393-5864",
            "fax_number": "330-393-9921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVES",
        "first_name": "FERNANDO",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2007-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OH",
            "license": "35053577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0672928",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00060248",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.