Individual provider Active NPI

Maria Sarma Vassilaros, M.D.

  • Addiction Medicine (Internal Medicine) Physician
  • Canfield, OH
National Provider Identifier
1427019959
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
License
35.056622 Issued in OH
Practice address
3726 Tippecanoe PL
Canfield, OH 44406-9068
Phone
(330) 533-6402
Fax
(330) 533-3183
NPI assigned
Apr 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) Physician 207RA0401X 35.056622 OH Primary
Internal Medicine Physician 207R00000X 35056622 OH

Addresses

Primary practice location

3726 Tippecanoe PL
Canfield, OH 44406-9068

Mailing address

3726 Tippecanoe PL
Canfield, OH 44406-9068
Phone (330) 533-6402

Other identifiers 1

IdentifierTypeStateIssuer
1427019959MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35056622OHMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1143936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1427019959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3726 TIPPECANOE PL",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069068",
            "telephone_number": "330-533-6402",
            "fax_number": "330-533-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3726 TIPPECANOE PL",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069068",
            "telephone_number": "330-533-6402",
            "fax_number": "330-533-3183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASSILAROS",
        "first_name": "MARIA",
        "middle_name": "SARMA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-02",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "OH",
            "license": "35.056622",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35056622",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427019959",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.