Jack Dawson, DO

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

34.015892 Issued in OH

Practice address

8423 Market St Ste 207
Boardman, OH 44512-6778

Phone

(330) 965-5490

Fax

(330) 965-5491

NPI assigned

Feb 8, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH, VA, DC3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Orthopedic Surgery

Education

Ohio University, College of Osteopathic Medicine, 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)

Hospital & facility affiliations

• Expand Health Skilled at Home LLC Home health agency, Youngstown, OH, CCN 369312
• Patriot Homecare, Inc Home health agency, Girard, OH, CCN 368406
• HMHP St Elizabeth Boardman Health Center Hospital, Boardman, OH, CCN 360276
• MH St Elizabeth Youngstown Hospital Hospital, Youngstown, OH, CCN 360064

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdawson186566@direct.bsmhealth.org

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.

• Mercy Health Physicians Youngstown Specialty Care LLC

  • Surgery Physician
  • Youngstown, OH
  • NPI 1649892225

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Arthritis & Sports Orthopaedics PC

  • Orthopaedic Surgery Physician
  • Sterling, VA
  • NPI 1558342840

  DC, Multi-Specialty

  Medicare reassignment NPD
• Mercy Health Physicians Youngstown Specialty Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Boardman, OH
  • NPI 1386316107
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Expand Health Skilled at Home LLC

  dba Expand Health at Home

  • Home Health Agency
  • Youngstown, OH
  • NPI 1548936156
  Care Compare affiliation
• Mercy Health Youngstown LLC

  dba Mercy Health St Elizabeth Youngstown Hospital

  • General Acute Care Hospital
  • Youngstown, OH
  • NPI 1548296106
  Care Compare affiliation
• Mercy Health Youngstown LLC

  dba Mercy Health St Elizabeth Boardman Hospital

  • General Acute Care Hospital
  • Youngstown, OH
  • NPI 1790868982
  Care Compare affiliation
• Mercy Health Youngstown LLC

  dba Mercy Health Youngstown Laboratory

  • Clinical Medical Laboratory
  • Youngstown, OH
  • NPI 1831600295

  Hospital

  Care Compare affiliation
• Patriot Homecare, Inc.

  • Home Health Agency
  • Girard, OH
  • NPI 1598061418
  Care Compare affiliation

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1528506607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8423 MARKET ST STE 207",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445126778",
            "telephone_number": "330-965-5490",
            "fax_number": "330-965-5491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8423 MARKET ST STE 207",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445126778",
            "telephone_number": "330-965-5490",
            "fax_number": "330-965-5491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 Royal Birkdale Dr",
            "address_purpose": "LOCATION",
            "city": "Columbiana",
            "state": "OH",
            "postal_code": "444088493",
            "country_code": "US",
            "telephone_number": "330-482-0937",
            "fax_number": "330-482-0941",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1044 Belmont Ave",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445041006",
            "country_code": "US",
            "telephone_number": "330-480-3990",
            "fax_number": "330-480-3522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "JACK",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-08",
        "last_updated": "2023-09-19",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": "0102207240",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "34.015892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0230609",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David a Wyatt, DDS, LLS
• David P. Esarco, D.C., LTD.
• Johny Davilma, MD
• Amanda Rae Davis, NP-C
• Haley Davis
• Daniel M Deangelo, D.D.S. M.S.
• Dominic John Deangelo, PA-C
• Robert Debiec, DPM
• Deborah L Sano PHD LLC
• Adrien Decena, M.D.

• Orthopaedic Surgery Physician in Boardman, OH
• Providers in Boardman, OH by specialty
• Orthopaedic Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.