Individual provider Active NPI

Brian Joseph Kassa

  • Physical Medicine & Rehabilitation Physician
  • Youngstown, OH
National Provider Identifier
1417513367
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
58.031112 Issued in OH
Practice address
1044 Belmont Ave # Meded2S
Youngstown, OH 44504-1006
Phone
(330) 480-2994
NPI assigned
May 16, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 58.031112 OH
Physical Medicine & Rehabilitation Physician 208100000X 58.031112 OH Primary

Addresses

Primary practice location

1044 Belmont Ave # Meded2S
Youngstown, OH 44504-1006

Mailing address

1100 Boardman Canfield Rd Apt 74C
Boardman, OH 44512-8054
Phone (248) 860-8662

Other practice location 1

4200 Regent St Ste 200
Columbus, OH 43219-6229
Phone (877) 581-2210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20221004002173 MI Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 5890171508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
Lake Erie Col of Osteo Med at Seton Hill Univ, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mendelson Orthopedics PCGroup PAC ID 8426008368, 69 clinicians

Practice addresses (Care Compare)

36622 5 Mile Rd
Livonia, MI 48154-1900
Phone (734) 542-0200

Hospital & facility affiliations

  • McLaren Port Huron Hospital, Port Huron, MI, CCN 230216

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58.031112OHMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Mendelson Orthopedics PC Current Accepting new patients
Mendelson Orthopedics PC CurrentSince Jul 15, 2024 Accepting new patients
Mendelson Orthopedics PC CurrentSince Jul 15, 2024 Accepting new patients
Mendelson Orthopedics PC PastSince Jul 21, 2024 Accepting new patients

Locations

7684 Solutions Ctr
#777684
Chicago, IL 60677

36622 5 Mile Rd
Livonia, MI 48154
Phone (734) 542-0200

14555 Levan Rd
Ste 215
Livonia, MI 48154
Phone (734) 542-0200

36622 5 Mile Rd
#101
Livonia, MI 48154

36622 5 Mile Rd
Ste 101
Livonia, MI 48154
Phone (734) 526-1791

600 Fort St
Ste 100
Port Huron, MI 48060
Phone (810) 987-9711

35735 Mound Rd
Sterling Heights, MI 48310
Phone (586) 261-1960

35735 Mound Rd
Ste 100
Sterling Heights, MI 48310
Phone (586) 261-1960

5107 Rochester Rd
Troy, MI 48085
Phone (248) 723-2477

500 Stephenson Hwy
#300
Troy, MI 48083
Phone (586) 439-6258

Interoperability endpoints

  • Direct secure messaging: bkassa815201@direct.hfhs.org

Organizations & group practices 4

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 1

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": "1557964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1417513367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 BOARDMAN CANFIELD RD APT 74C",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445128054",
            "telephone_number": "248-860-8662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 BELMONT AVE # MEDED2S",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041006",
            "telephone_number": "330-480-2994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4200 Regent St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432196229",
            "country_code": "US",
            "telephone_number": "877-581-2210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KASSA",
        "first_name": "BRIAN",
        "middle_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-16",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "58.031112",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OH",
            "license": "58.031112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.