NPIMap

Individual provider Active NPI

Nicole Marie Pugh, CRNA

  • Certified Registered Nurse Anesthetist
  • Youngstown, OH
National Provider Identifier
1629490354
Registry record updated Apr 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN334168-COA1 Issued in OH
Practice address
1044 Belmont Ave
Youngstown, OH 44504-1006
Phone
(330) 480-3658
Fax
(330) 480-3439
NPI assigned
Jan 15, 2014
Last updated
Apr 7, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN334168-COA1 OH Primary

Addresses

Primary practice location

1044 Belmont Ave
Youngstown, OH 44504-1006

Mailing address

4135 Boardman Canfield Rd
Suite 101
Canfield, OH 44406-9803
Phone (330) 286-5330

Other identifiers 2

IdentifierTypeStateIssuer
0096690MedicaidOH
H254610OtherOHMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140205001027 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 3173752565 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bel-Park Anesthesia Associates, Inc.Group PAC ID 8628974904, 158 clinicians
Ohio Anesthesia Group, IncGroup PAC ID 9537222138, 130 clinicians

Practice addresses (Care Compare)

1044 Belmont Ave
Youngstown, OH 44504-1006
Phone (330) 480-3658

3557 Embassy Pkwy
Akron, OH 44333-8358
Phone (440) 350-0832

667 Eastland Seave
Warren, OH 44484-4503
Phone (330) 841-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
71.12
Promoting interoperability
100
Improvement activities
40
Cost
75.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc Current Accepting new patients
Anesthesia & Intensive Care Consultants,Inc. Nurse Anesthetist, Certified Registered CurrentSince Jun 22, 2022 Accepting new patients
Northstar Anesthesia of Ohio LLC CurrentSince Aug 24, 2016 Accepting new patients
Bel-Park Anesthesia Associates, Inc. Nurse Anesthetist, Certified Registered CurrentSince Feb 3, 2014 Accepting new patients
Southwest Ohio Anesthesia Consultants LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 22, 2022 Accepting new patients
Triad Health Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2021 Accepting new patients
University Hospitals Medical Group Inc CurrentSince Aug 6, 2023 Accepting new patients
University Primary Care Practices Inc CurrentSince Aug 6, 2023 Accepting new patients
The Gastroenterology Clinic & Endoscopy Center Inc CurrentSince Jan 1, 2016 Accepting new patients
University Primary Care Practices Inc CurrentSince Aug 6, 2023 Accepting new patients
The Surgery Center at Southwoods, LLC Past Accepting new patients

Locations

3000 Hospital Dr
Batavia, OH 45103
Phone (513) 557-3209

4135 Boardman Canfield Rd
Ste 101
Canfield, OH 44406
Phone (330) 532-7215

7500 State Rd
Cincinnati, OH 45255
Phone (513) 624-4034

11100 Euclid Ave
Cleveland Heights, OH 44106

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

870 W Main St
Geneva, OH 44041
Phone (440) 415-0258

2615 E High St
Springfield, OH 45505
Phone (888) 861-3994

1622 E Market St
Warren, OH 44483
Phone (330) 399-7215

100 Debartolo Pl
Ste 200
Youngstown, OH 44512
Phone (330) 965-7828

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

250 Debartolo Pl
Ste 1000
Youngstown, OH 44512
Phone (330) 314-9100

7629 Market St
Ste 250
Youngstown, OH 44512
Phone (330) 729-9480

7630 Southern Blvd
Youngstown, OH 44512
Phone (330) 729-8000

Interoperability endpoints

  • Direct secure messaging: nicole.pugh.p1@direct.gastroandhepatology.nextgenshare.com
  • Direct secure messaging: npugh33027@ehrdirect.uhhospitals.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396828800000",
    "number": "1629490354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4135 BOARDMAN CANFIELD RD",
            "address_2": "SUITE 101",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069803",
            "telephone_number": "330-286-5330",
            "fax_number": "330-286-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041006",
            "telephone_number": "330-480-3658",
            "fax_number": "330-480-3439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGH",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-15",
        "last_updated": "2014-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN334168-COA1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0096690",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "H254610",
            "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 Apr 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.