Premium Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PREMIUM PEDIATRICS

Practice address

918 Youngstown Warren Rd
Suite C
Niles, OH 44446-4623

Phone

(330) 652-3100

Fax

(330) 652-1231

NPI assigned

Dec 13, 2005

Organization subpart

No

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

Authorized official

Name

Carrie Oklota-Fadell, MD

Title

President

Phone

(330) 652-3100

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Melissa Valantine Ferrara

  • Pediatrics Physician
  • Niles, OH
  • NPI 1518940261
  NPD (past)
• Jeffrey Thomas Walsh, PA-C

  • Medical Physician Assistant
  • Niles, OH
  • NPI 1265608780
  NPD (past)
• Teresa A Yocum, MD

  • Pediatrics Physician
  • Niles, OH
  • NPI 1346223096
  NPD (past)

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497730550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 YOUNGSTOWN WARREN RD",
            "address_2": "SUITE C",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444464623",
            "telephone_number": "330-652-3100",
            "fax_number": "330-652-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 YOUNGSTOWN WARREN RD",
            "address_2": "SUITE C",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444464623",
            "telephone_number": "330-652-3100",
            "fax_number": "330-652-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OKLOTA-FADELL",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-652-3100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2600760",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eugene D Podolsky, DPM
• Elizabeth Pojman
• Michael James Polichetti, MSW, LISW
• Joseph A Potocki, DO
• Amanda Praytor
• Deanna Prezioso
• Daren Price Jr
• Kiara Price
• Primary Healthcare Group Inc
• Jillian Priscilla

• Pediatrics Physician in Niles, OH
• Providers in Niles, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.