NPIMap

Individual provider Active NPI

Kaitlyn E Buxman, PA

  • Physician Assistant
  • Youngstown, OH
National Provider Identifier
1497274054
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.005197RX Issued in OH
Practice address
1001 Belmont Ave
Youngstown, OH 44504-1003
Phone
(330) 747-1106
Fax
(330) 747-0491
NPI assigned
Sep 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 50.005197RX OH
Physician Assistant 363A00000X 50.005197RX OH Primary

Addresses

Primary practice location

1001 Belmont Ave
Youngstown, OH 44504-1003

Mailing address

1001 Belmont Ave
Youngstown, OH 44504-1003
Phone (330) 747-1106

Other identifiers 1

IdentifierTypeStateIssuer
0250349MedicaidOH

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
I20171115000365 OH Practitioner - Physician Assistant 2961768536 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Youngstown Specialty Care LLCGroup PAC ID 3476950296, 463 clinicians

Practice addresses (Care Compare)

1044 Belmont Ave
Youngstown, OH 44504-1006

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

8401 Market St
Boardman, OH 44512-6725
Phone (330) 480-2040

Hospital & facility affiliations

  • MH St Elizabeth Youngstown Hospital Hospital, Youngstown, OH, CCN 360064
  • HMHP St Elizabeth Boardman Health Center Hospital, Boardman, OH, CCN 360276
  • MH St Joseph Warren Hospital Hospital, Warren, OH, CCN 360161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.005197RXOHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown, LLC Physician Assistant CurrentSince Aug 5, 2019 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC Physician Assistant Past Accepting new patients

Locations

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

627 Eastland Ave SE
Ste 301
Warren, OH 44484
Phone (330) 392-3099

1001 Belmont Ave
Youngstown, OH 44504
Phone (330) 747-1106

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: kbuxman363148@direct.bsmhealth.org

Organizations & group practices 6

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 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": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1497274054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041003",
            "telephone_number": "330-747-1106",
            "fax_number": "330-747-0491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041003",
            "telephone_number": "330-747-1106",
            "fax_number": "330-747-0491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUXMAN",
        "first_name": "KAITLYN",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-14",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "50.005197RX",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005197RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0250349",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.