Individual provider Active NPI

Thomas Joseph Rudnicki, D.O.

  • Internal Medicine Physician
  • Canfield, OH
National Provider Identifier
1568873503
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34.013006 Issued in OH
Practice address
61 Talsman Dr
Canfield, OH 44406-1207
Phone
(330) 533-2218
Fax
(330) 533-6111
NPI assigned
May 13, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34.013006 OH Primary

Addresses

Primary practice location

61 Talsman Dr
Canfield, OH 44406-1207

Mailing address

61 Talsman Dr
Canfield, OH 44406-1207
Phone (330) 533-2218

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
I20170913003775 OH Practitioner - Internal Medicine 3173896156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2014
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)

1044 Belmont Ave
Youngstown, OH 44504-1006

61 Talsman Dr
Canfield, OH 44406-1207
Phone (330) 729-3851

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.013006OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown LLC CurrentSince Sep 5, 2017 Accepting new patients
Mercy Health Physicians Youngstown, LLC Internal Medicine CurrentSince Sep 5, 2017 Accepting new patients

Locations

61 Talsman Dr
Canfield, OH 44406
Phone (330) 533-2218

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: trudnicki56859@direct.bsmhealth.org

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 8

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": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1568873503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 TALSMAN DR",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444061207",
            "telephone_number": "330-533-2218",
            "fax_number": "330-533-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 TALSMAN DR",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444061207",
            "telephone_number": "330-533-2218",
            "fax_number": "330-533-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDNICKI",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34.013006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canfield, OH

Sources for this page

Verify at the official NPI Registry.