NPIMap

Organization Active NPI

First Medical Associates Inc

  • Internal Medicine Physician
  • Boardman, OH
National Provider Identifier
1609877687
Registry record updated Oct 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35100173D Issued in OH
Legal business name
FIRST MEDICAL ASSOCIATES INC
Practice address
7341 Eisenhower Dr
Boardman, OH 44512-5900
Phone
(330) 726-1138
Fax
(330) 726-6128
NPI assigned
Aug 2, 2005
Last updated
Oct 29, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2014

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

Authorized official

Name
Dr. Thomas Nicholas Detesco, M.D.NPI 1013911403
Title
President
Phone
(330) 726-1138

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35100173D OH Primary

Addresses

Primary practice location

7341 Eisenhower Dr
Boardman, OH 44512-5900

Mailing address

7341 Eisenhower Dr
Boardman, OH 44512-5900
Phone (330) 726-1138

Other identifiers 1

IdentifierTypeStateIssuer
0518470MedicaidOH

Other names 1

  • First Medical Associates Other name

National Provider Directory

National Provider Directory

Locations

7341 Eisenhower Dr
Ste A
Boardman, OH 44512
Phone (330) 729-8960

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414540800000",
    "number": "1609877687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7341 EISENHOWER DR",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445125900",
            "telephone_number": "330-726-1138",
            "fax_number": "330-726-6128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7341 EISENHOWER DR",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445125900",
            "telephone_number": "330-726-1138",
            "fax_number": "330-726-6128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST MEDICAL ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2014-10-29",
        "status": "A",
        "authorized_official_last_name": "DETESCO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "NICHOLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-726-1138",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35100173D",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0518470",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "First Medical Associates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Boardman, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; 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.