Individual provider Active NPI

Jessica Marie Fryda

  • Family Nurse Practitioner
  • Youngstown, OH
National Provider Identifier
1427646785
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0028478 Issued in OH
Practice address
1044 Belmont Ave
Youngstown, OH 44504-1006
Phone
(330) 480-2040
Fax
(330) 480-2071
NPI assigned
Jan 4, 2021
Last updated
May 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X LE-00034920 OH
Family Nurse Practitioner 363LF0000X APRN.CNP.0028478 OH Primary

Addresses

Primary practice location

1044 Belmont Ave
Youngstown, OH 44504-1006

Mailing address

1044 Belmont Ave
Youngstown, OH 44504-1006
Phone (330) 480-2040

Other practice location 1

3154 Howell Dr
Youngstown, OH 44514-2459
Phone (330) 507-0443

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210514001026 OH Practitioner - Nurse Practitioner 8022427467 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8401 Market St
Boardman, OH 44512-6725
Phone (330) 729-2929

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
LE-00034920OHMDNurse Practitioner
APRN.CNP.0028478OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown, LLC Nurse Practitioner CurrentSince Jun 21, 2021 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC Nurse Practitioner CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown LLC CurrentSince Jun 21, 2021 Accepting new patients

Locations

1701 Mercy Health Pl
Cincinnati, OH 45237
Phone (513) 952-5000

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

8401 Market St
Youngstown, OH 44512
Phone (330) 729-2929

Interoperability endpoints

  • Direct secure messaging: jfryda84170@direct.bsmhealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1609718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1427646785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041006",
            "telephone_number": "330-480-2040",
            "fax_number": "330-480-2071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041006",
            "telephone_number": "330-480-2040",
            "fax_number": "330-480-2071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3154 Howell Dr",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445142459",
            "country_code": "US",
            "telephone_number": "330-507-0443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRYDA",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-04",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "LE-00034920",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0028478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.