Individual provider Active NPI

Nicholas Frank Agnesi, M.D.

  • Vascular Surgery Physician
  • Boardman, OH
National Provider Identifier
1306089834
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
35. 055333 Issued in OH
Practice address
813 Kentwood Dr
Boardman, OH 44512-5004
Phone
(330) 533-1570
Fax
(330) 953-2368
NPI assigned
Apr 14, 2009
Last updated
Jan 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35. 055333 NY
Vascular Surgery Physician 2086S0129X 35. 055333 OH Primary

Addresses

Primary practice location

813 Kentwood Dr
Boardman, OH 44512-5004

Mailing address

813 Kentwood Dr
Boardman, OH 44512-5004
Phone (330) 533-1570

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
I20100728000294 OH Practitioner - General Surgery 0244208528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Northeastern Ohio University College of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

813 Kentwood Dr
Boardman, OH 44512-5004
Phone (330) 533-1570

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal70

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35. 055333NYMDSurgery Physician
35. 055333OHMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Hair Restoration of Ohio LLC Surgery CurrentSince Apr 6, 2009 Accepting new patients
The Circulatory Center of PA, Inc. Surgery Past Accepting new patients

Locations

3869 Starrs Centre Dr
Canfield, OH 44406
Phone (330) 533-1570

813 Kentwood Dr
Youngstown, OH 44512
Phone (330) 533-1570

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": "1239667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1306089834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 KENTWOOD DR",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445125004",
            "telephone_number": "330-533-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 KENTWOOD DR",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445125004",
            "telephone_number": "330-533-1570",
            "fax_number": "330-953-2368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGNESI",
        "first_name": "NICHOLAS",
        "middle_name": "FRANK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-14",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "35. 055333",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OH",
            "license": "35. 055333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

Verify at the official NPI Registry.