NPIMap

Individual provider Active NPI

Christian Yeasted, M.D.

  • Family Medicine Physician
  • Austintown, OH
National Provider Identifier
1508154279
Registry record updated Feb 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.126681 Issued in OH
Practice address
5533 Mahoning Ave
Ste D
Austintown, OH 44515-2366
Phone
(330) 793-2701
Fax
(330) 793-8688
NPI assigned
Jul 15, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.126681 OH Primary

Addresses

Primary practice location

5533 Mahoning Ave
Ste D
Austintown, OH 44515-2366

Mailing address

5533 Mahoning Ave
Ste D
Austintown, OH 44515-2366
Phone (330) 793-2701

Other identifiers 2

IdentifierTypeStateIssuer
0137845MedicaidOH
H379990OtherOHMEDICARE PTAN

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
I20150806010838 OH Practitioner - Family Practice 5294049011 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Temple University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Youngstown, LLCGroup PAC ID 9234318270, 116 clinicians

Practice addresses (Care Compare)

5533 Mahoning Ave
Suite D
Austintown, OH 44515-2366
Phone (330) 793-2701

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.126681OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown LLC CurrentSince Aug 31, 2015 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown, LLC Family Medicine CurrentSince Aug 31, 2015 Accepting new patients
Mercy Health Youngstown LLC Past Accepting new patients

Locations

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

5533 Mahoning Ave
Ste D
Youngstown, OH 44515
Phone (330) 793-2701

5533 Mahoning Ave
Fl 2
Youngstown, OH 44515
Phone (330) 480-3533

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

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

Interoperability endpoints

  • Direct secure messaging: cyeasted187050@direct.bsmhealth.org

Organizations & group practices 5

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": "1310688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1508154279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5533 MAHONING AVE",
            "address_2": "STE D",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445152366",
            "telephone_number": "330-793-2701",
            "fax_number": "330-793-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5533 MAHONING AVE",
            "address_2": "STE D",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445152366",
            "telephone_number": "330-793-2701",
            "fax_number": "330-793-8688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEASTED",
        "first_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-15",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.126681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0137845",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "H379990",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austintown, OH

Sources for this page

Verify at the official NPI Registry.