Individual provider Active NPI

Nikolay Gatalyak, D.P.M.

  • Podiatrist
  • Canton, OH
National Provider Identifier
1508022666
Registry record updated Jul 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36003582 Issued in OH
Practice address
3731 Whipple Ave NW
Canton, OH 44718-2933
Phone
(330) 493-3363
NPI assigned
Jul 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 36003582 OH Primary

Addresses

Primary practice location

3731 Whipple Ave NW
Canton, OH 44718-2933

Mailing address

3731 Whipple Ave NW
Canton, OH 44718-2933
Phone (330) 493-3363

Other identifiers 1

IdentifierTypeStateIssuer
0052012MedicaidOH

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110817000683 OH Practitioner - Podiatry 9739358268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

125 Canton Rd NW
Carrollton, OH 44615-1009
Phone (330) 627-7676

Hospital & facility affiliations

  • Mercy Medical Center Hospital, Canton, OH, CCN 360070
  • Aultman Hospital Hospital, Canton, OH, CCN 360084

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue174
Removal of skin lesions1-10
Removal of nail tissue740
Removal or shaving of skin growth318
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36003582OHMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ankle and Foot Centers of Ohio LLC Podiatrist CurrentSince Apr 6, 2016 Accepting new patients
Ankle and Foot Centers of Ohio LLC Podiatrist CurrentSince Mar 24, 2016 Accepting new patients

Locations

3731 Whipple Ave NW
Canton, OH 44718
Phone (330) 493-4945

125 Canton Rd NW
Carrollton, OH 44615
Phone (330) 627-7300

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18623/brand/1/csg/1/fhir/r4
  • Direct secure messaging: nikolay.gatalyak.1@18623.direct.athenahealth.com

Organizations & group practices 2

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 2

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": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468368000000",
    "number": "1508022666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3731 WHIPPLE AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182933",
            "telephone_number": "330-493-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3731 WHIPPLE AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182933",
            "telephone_number": "330-493-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATALYAK",
        "first_name": "NIKOLAY",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-29",
        "last_updated": "2016-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36003582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0052012",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.