NPIMap

Individual provider Active NPI

Jason Richard Delatore, M.D.

  • Vascular Surgery Physician
  • Youngstown, OH
National Provider Identifier
1649247529
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
35.082322 Issued in OH
Practice address
1044 Belmont Ave
Youngstown, OH 44504-1006
Phone
(330) 744-2118
Fax
(330) 747-6843
NPI assigned
Mar 1, 2006
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 35.082322 OH Primary

Addresses

Primary practice location

1044 Belmont Ave
Youngstown, OH 44504-1006

Mailing address

1044 Belmont Ave
Youngstown, OH 44504-1006
Phone (330) 744-2118

Other identifiers 3

IdentifierTypeStateIssuer
1028546510001MedicaidPA
4108072OtherOHMEDICARE PTAN
2414211MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100902000299 OH Practitioner - Vascular Surgery 5991808958 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Ohio State University College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1001 Belmont Ave
Youngstown, OH 44504-1003
Phone (330) 747-6446

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.082322OHMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown, LLC Current Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC Current Accepting new patients
Mercy Health Physicians Youngstown LLC CurrentSince Jun 6, 2011 Accepting new patients
Mercy Health Youngstown LLC Past Accepting new patients

Locations

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

627 Eastland Ave SE
Ste 301
Warren, OH 44484
Phone (330) 392-3099

1001 Belmont Ave
Youngstown, OH 44504
Phone (330) 747-1106

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

540 Parmalee Ave
Ste 410
Youngstown, OH 44510
Phone (330) 707-4553

Interoperability endpoints

  • Direct secure messaging: jdelatore34844@direct.bsmhealth.org

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.

Hospital & facility affiliations 5

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": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1649247529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041006",
            "telephone_number": "330-744-2118",
            "fax_number": "330-747-6843"
        },
        {
            "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": "330-744-2118",
            "fax_number": "330-747-6843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELATORE",
        "first_name": "JASON",
        "middle_name": "RICHARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OH",
            "license": "35.082322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1028546510001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "4108072",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2414211",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.