Individual provider Active NPI

Anita Jeyakumar, MD

  • Otolaryngology Physician
  • Boardman, OH
National Provider Identifier
1548362486
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
35.087978 Issued in OH
Practice address
8423 Market St Ste 210
Boardman, OH 44512-6778
Phone
(330) 729-1934
Fax
(330) 729-1861
NPI assigned
Sep 1, 2006
Last updated
Jan 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 35.087978 OH Primary
Pediatric Otolaryngology Physician 207YP0228X 35.087978 OH

Addresses

Primary practice location

8423 Market St Ste 210
Boardman, OH 44512-6778

Mailing address

8423 Market St Ste 210
Boardman, OH 44512-6778
Phone (330) 729-1934

Other practice location 1

1 Perkins Sq
Akron, OH 44308-1063
Phone (330) 543-4930

Other identifiers 1

IdentifierTypeStateIssuer
2678115MedicaidOH

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060914000445 OH Practitioner - Otolaryngology 7416951975 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Meharry Medical College School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hears LLCGroup PAC ID 0042750200, 2 clinicians

Practice addresses (Care Compare)

632 E Market St
Suite B
Akron, OH 44304-1661
Phone (866) 644-3277

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.087978OHMDPediatric Otolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Medical Center of Akron Current Accepting new patients
Children's Hospital Medical Center of Akron CurrentSince Apr 11, 2018 Accepting new patients
Children's Hospital Medical Center of Akron CurrentSince Apr 11, 2018 Accepting new patients
Hears LLC CurrentSince Jul 1, 2024 Accepting new patients
United Podiatry Inc PastSince Jul 1, 2024 Accepting new patients
Louisiana State University School of Med in New Orleans Faculty Grou Past Accepting new patients

Locations

1 Perkins Sq
Akron, OH 44308
Phone (330) 543-8050

632 E Market St
Ste B
Akron, OH 44304
Phone (330) 864-8501

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

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1548362486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8423 MARKET ST STE 210",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445126778",
            "telephone_number": "330-729-1934",
            "fax_number": "330-729-1861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8423 MARKET ST STE 210",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445126778",
            "telephone_number": "330-729-1934",
            "fax_number": "330-729-1861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Perkins Sq",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443081063",
            "country_code": "US",
            "telephone_number": "330-543-4930",
            "fax_number": "330-543-4931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEYAKUMAR",
        "first_name": "ANITA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "35.087978",
            "primary": true
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "OH",
            "license": "35.087978",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2678115",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

Verify at the official NPI Registry.