NPIMap

Individual provider Active NPI

Suzan L Selim, MD

  • Internal Medicine Physician
  • Boardman, OH
National Provider Identifier
1447264825
Registry record updated Dec 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35057074 Issued in OH
Practice address
7341 Eisenhower Dr
Boardman, OH 44512-5900
Phone
(330) 726-1138
Fax
(330) 726-6128
NPI assigned
Jul 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2020

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 35057074 OH Primary

Addresses

Primary practice location

7341 Eisenhower Dr
Boardman, OH 44512-5900

Mailing address

7341 Eisenhower Dr
Boardman, OH 44512-5900
Phone (330) 726-1138

Other practice location 1

901 Trailwood Dr
Youngstown, OH 44512-5008
Phone (330) 726-3000

Other identifiers 1

IdentifierTypeStateIssuer
0714098MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060907000326 OH Practitioner - Internal Medicine 5294739181 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Health Physicians Youngstown, LLCGroup PAC ID 9234318270, 116 clinicians

Practice addresses (Care Compare)

410 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-8000

7341 Eisenhower Dr
Boardman, OH 44512-5900
Phone (330) 726-1138

9471 Market St
North Lima, OH 44452-8702

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35057074OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Ohio, Professional Corporation Internal Medicine CurrentSince Aug 1, 2020 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown LLC CurrentSince Jan 4, 2021 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Hospitalist Medicine Physicians of Richland County, LTD Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown, LLC Internal Medicine Current Accepting new patients
Austinwoods Nursing Center Inc Past Accepting new patients

Locations

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

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

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

250 E Federal St
Fl 4
Youngstown, OH 44503
Phone (330) 884-7010

7341 Eisenhower Dr
Youngstown, OH 44512
Phone (330) 726-1138

1044 Belmont Ave
#4
Youngstown, OH 44504

Interoperability endpoints

  • Direct secure messaging: sselim34621@direct.bsmhealth.org

Organizations & group practices 7

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 6

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1447264825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7341 EISENHOWER DR",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445125900",
            "telephone_number": "330-726-1138",
            "fax_number": "330-726-6128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7341 EISENHOWER DR",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445125900",
            "telephone_number": "330-726-1138",
            "fax_number": "330-726-6128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 Trailwood Dr",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445125008",
            "country_code": "US",
            "telephone_number": "330-726-3000",
            "fax_number": "330-726-2612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SELIM",
        "first_name": "SUZAN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35057074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0714098",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

Verify at the official NPI Registry.