Individual provider Active NPI

Tiffany Victor, D.O.

  • Internal Medicine Physician
  • Warren, OH
National Provider Identifier
1295046514
Registry record updated Apr 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34.010992 Issued in OH
Practice address
1615 N River Rd NE
Warren, OH 44483-2437
Phone
(330) 372-2333
Fax
(330) 373-1111
NPI assigned
Jul 1, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34.010992 OH Primary

Addresses

Primary practice location

1615 N River Rd NE
Warren, OH 44483-2437

Mailing address

1615 N River Rd NE
Warren, OH 44483-2437
Phone (330) 372-2333

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
I20140415000622 OH Practitioner - Internal Medicine 6204068836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ohio University, College of Osteopathic Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Justin P. Mikula, M.D., Inc.Group PAC ID 9436176195, 2 clinicians

Practice addresses (Care Compare)

1615 N River Rd NE
Suite 1
Warren, OH 44483-2437
Phone (330) 372-2333

Hospital & facility affiliations

  • Patriot Homecare, Inc Home health agency, Girard, OH, CCN 368406
  • Expand Health Skilled at Home LLC Home health agency, Youngstown, OH, CCN 369312
  • TLC Home Healthcare LLC Home health agency, Warren, OH, CCN 369258
  • MH St Joseph Warren Hospital Hospital, Warren, OH, CCN 360161
  • MH St Elizabeth Youngstown Hospital Hospital, Youngstown, OH, CCN 360064
  • Surgical Hospital at Southwoods Hospital, Youngstown, OH, CCN 360352
  • HMHP St Elizabeth Boardman Health Center Hospital, Boardman, OH, CCN 360276

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.010992OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Justin P. Mikula, M.D., Inc. Internal Medicine CurrentSince Jan 21, 2019 Accepting new patients

Locations

1615 N River Rd NE
Warren, OH 44483
Phone (330) 372-2333

1350 E Market St
Warren, OH 44483
Phone (330) 841-5969

1615 N River Rd NE
#1
Warren, OH 44483
Phone (330) 372-2333

Interoperability endpoints

  • Direct secure messaging: tvictor16975@direct.bsmhealth.org

Organizations & group practices 1

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 9

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": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1295046514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 N RIVER RD NE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444832437",
            "telephone_number": "330-372-2333",
            "fax_number": "330-373-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 N RIVER RD NE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444832437",
            "telephone_number": "330-372-2333",
            "fax_number": "330-373-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTOR",
        "first_name": "TIFFANY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-01",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34.010992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.