Individual provider Active NPI

Nicholas Chris Kreatsoulas, D.O.

  • Hospice and Palliative Medicine (Emergency Medicine) Physician
  • Youngstown, OH
National Provider Identifier
1659479327
Registry record updated Jun 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Emergency Medicine) PhysicianTaxonomy code 207PH0002X
License
34.005309 Issued in OH
Practice address
1044 Belmont Ave
Youngstown, OH 44504
Phone
(330) 480-2949
Fax
(330) 480-2071
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Emergency Medicine) Physician 207PH0002X 34.005309 OH Primary
Emergency Medicine Physician 207P00000X 34-005309 OH

Addresses

Primary practice location

1044 Belmont Ave
Youngstown, OH 44504

Mailing address

1044 Belmont Ave
Youngstown, OH 44504-1006
Phone (330) 480-2949

Other identifiers 1

IdentifierTypeStateIssuer
0937786MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1831WVMDGeneral Practice Dentistry
34-005309OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
4M Emergency Systems LLC Emergency Medicine Past Accepting new patients
Mahoning Valley Emergency Specialists LLC Emergency Medicine Past Accepting new patients
Brown Memorial Hospital Emergency Medicine Past Accepting new patients
4M Emergency Systems of West Virginia Emergency Medicine Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1659479327",
    "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": "330-480-2949",
            "fax_number": "330-480-2071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "44504",
            "telephone_number": "330-480-2949",
            "fax_number": "330-480-2071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREATSOULAS",
        "first_name": "NICHOLAS",
        "middle_name": "CHRIS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PH0002X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Hospice and Palliative Medicine",
            "state": "OH",
            "license": "34.005309",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34-005309",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0937786",
            "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 Jun 5, 2018; 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.