NPIMap

Organization Active NPI

Ohio Anesthesia Group, Inc

  • Anesthesiology Physician
  • Canton, OH
National Provider Identifier
1639348113
Registry record updated Mar 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
OHIO ANESTHESIA GROUP, INC
Practice address
1320 Mercy Dr NW
Canton, OH 44708-2614
Phone
(330) 656-5215
NPI assigned
Feb 28, 2008
Last updated
Mar 15, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2019

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

Authorized official

Name
Mr. Alfred J MartelloNPI 1538111281
Title
Authorised Representative
Phone
(330) 656-5215

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

1320 Mercy Dr NW
Canton, OH 44708-2614

Mailing address

4665 Douglas Cir NW Ste 100
Canton, OH 44718-3673
Phone (330) 499-5700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090108000069 OH Part B Supplier - Clinic/Group Practice 9537222138 Receives reassigned benefits from 554 practitioners
Practice locations: Middleburg Heights, OH; North Canton, OH; Oakwood Village, OH; Painesville, OH; Parma, OH; Pepper Pike, OH; Port Clinton, OH; Sandusky, OH…

National Provider Directory

National Provider Directory

Locations

4450 Belden Village St NW
Ste 307
Canton, OH 44718
Phone (330) 499-5700

4665 Douglas Cir NW
Ste 100
Canton, OH 44718
Phone (330) 499-5700

320 Oxford St
Dover, OH 44622
Phone (330) 365-2101

15028 State Route 224 E
Findlay, OH 45840
Phone (419) 427-3040

7442 Frank Ave NW
North Canton, OH 44720
Phone (330) 305-0838

Practitioners & affiliated clinicians

Practitioners 561

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.

View all 561

NPI Registry JSON

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552608000000",
    "number": "1639348113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4665 DOUGLAS CIR NW STE 100",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183673",
            "telephone_number": "330-499-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 MERCY DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082614",
            "telephone_number": "330-656-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO ANESTHESIA GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-28",
        "last_updated": "2019-03-15",
        "status": "A",
        "authorized_official_last_name": "MARTELLO",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "AUTHORISED REPRESENTATIVE",
        "authorized_official_telephone_number": "330-656-5215",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.