NPIMap

Organization Active NPI

Primary Care Associates

  • Internal Medicine Physician
  • Youngstown, OH
National Provider Identifier
1508962564
Registry record updated Jan 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35-05-9111 Issued in OH
Legal business name
PRIMARY CARE ASSOCIATES
Practice address
602 Parmalee Ave
Suite 400
Youngstown, OH 44510-1653
Phone
(330) 747-8611
Fax
(330) 747-8027
NPI assigned
Sep 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2010

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

Authorized official

Name
Dr. Santuccio Ricciardi, MD
Title
President
Phone
(330) 747-8611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 35-05-9111 OH Primary

Addresses

Primary practice location

602 Parmalee Ave
Suite 400
Youngstown, OH 44510-1653

Mailing address

602 Parmalee Ave
Suite 400
Youngstown, OH 44510-1653
Phone (330) 747-8611

Other identifiers 1

IdentifierTypeStateIssuer
2181866MedicaidOH

National Provider Directory

National Provider Directory

Locations

602 Parmalee Ave
Ste 400
Youngstown, OH 44510
Phone (330) 747-8611

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262822400000",
    "number": "1508962564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 PARMALEE AVE",
            "address_2": "SUITE 400",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445101653",
            "telephone_number": "330-747-8611",
            "fax_number": "330-747-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 PARMALEE AVE",
            "address_2": "SUITE 400",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445101653",
            "telephone_number": "330-747-8611",
            "fax_number": "330-747-8027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2010-01-07",
        "status": "A",
        "authorized_official_last_name": "RICCIARDI",
        "authorized_official_first_name": "SANTUCCIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-747-8611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-05-9111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2181866",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 7, 2010; 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.