NPIMap

Organization Active NPI

Mahoning Valley Wound Care, Inc.

Doing business as Felix a. Pesa, M.D.

  • Vascular Surgery Physician
  • Youngstown, OH
National Provider Identifier
1467633149
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
34025917 Issued in OH
Legal business name
MAHONING VALLEY WOUND CARE, INC.
Doing business as
Felix a. Pesa, M.D.
Practice address
540 Parmalee Ave
Suite 610
Youngstown, OH 44510-1716
Phone
(330) 480-2078
NPI assigned
Nov 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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

Authorized official

Name
Dr. Felix A Pesa
Title
Owner
Phone
(330) 480-2078

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X 34025917 OH Primary

Addresses

Primary practice location

540 Parmalee Ave
Suite 610
Youngstown, OH 44510-1716

Mailing address

540 Parmalee Ave
Suite 610
Youngstown, OH 44510-1716
Phone (330) 480-2078

Other identifiers 4

IdentifierTypeStateIssuer
000000291311OtherOHANTHEM
341107457027OtherOHCARESOURCE
0118938MedicaidOH
P00199613OtherOHMEDICARE/RR

Other names 1

  • FELIX A. PESA, M.D. Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327536000000",
    "number": "1467633149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 PARMALEE AVE",
            "address_2": "SUITE 610",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445101716",
            "telephone_number": "330-480-2078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 PARMALEE AVE",
            "address_2": "SUITE 610",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445101716",
            "telephone_number": "330-480-2078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHONING VALLEY WOUND CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-21",
        "last_updated": "2012-01-26",
        "status": "A",
        "authorized_official_last_name": "PESA",
        "authorized_official_first_name": "FELIX",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-480-2078",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "OH",
            "license": "34025917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000291311",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "341107457027",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0118938",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE/RR",
            "identifier": "P00199613",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FELIX A. PESA, M.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; 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.