Individual provider Active NPI

Aneta J Homer, MD

  • Internal Medicine Physician
  • Boardman, OH
National Provider Identifier
1659570448
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.092671 Issued in OH
Practice address
7000 South Ave Ste 2
Boardman, OH 44512-3644
Phone
(330) 314-9140
Fax
(330) 259-9721
NPI assigned
Jul 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.092671 OH Primary

Addresses

Primary practice location

7000 South Ave Ste 2
Boardman, OH 44512-3644

Mailing address

7000 South Ave Ste 2
Boardman, OH 44512-3644
Phone (330) 314-9140

Other identifiers 1

IdentifierTypeStateIssuer
0105995MedicaidOH

Other names 1

  • Dr. Aneta Jedrzejczyk Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140721002481 OH Practitioner - Internal Medicine 3173764578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Cincinnati College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Triad Health Services LLCGroup PAC ID 9032367917, 252 clinicians

Practice addresses (Care Compare)

250 Debartolo PL
Youngstown, OH 44512-6026

7629 Market St
Youngstown, OH 44512-6051

901 Trailwood Dr
Youngstown, OH 44512-5008
Phone (330) 726-3000

Hospital & facility affiliations

  • Patriot Homecare, Inc Home health agency, Girard, OH, CCN 368406
  • Akeso Home Health Care Inc Home health agency, Canfield, OH, CCN 368475
  • Hospice of the Valley, Inc Hospice, Girard, OH, CCN 361538
  • Akeso Home Hospice Inc Hospice, Canfield, OH, CCN 361707
  • Surgical Hospital at Southwoods Hospital, Youngstown, OH, CCN 360352
  • HMHP St Elizabeth Boardman Health Center Hospital, Boardman, OH, CCN 360276
  • MH St Elizabeth Youngstown Hospital Hospital, Youngstown, OH, CCN 360064
  • Shepherd of the Valley-Boardman Nursing home, Youngstown, OH, CCN 365580
  • Shepherd of the Valley Poland Nursing home, Poland, OH, CCN 366453

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.092671OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Triad Health Services, LLC Internal Medicine CurrentSince May 12, 2020 Accepting new patients
The Surgery Center at Southwoods, LLC Past Accepting new patients
Southwoods Health at Home, LLC PastSince Sep 1, 2021 Accepting new patients
Shepherd of the Valley Lutheran Retirement Services, Inc. Past Accepting new patients
Shepherd of the Valley Lutheran Retirement Services, Inc. Past Accepting new patients

Locations

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

7000 South Ave
Ste 2
Youngstown, OH 44512
Phone (330) 726-3456

901 Trailwood Dr
Youngstown, OH 44512
Phone (330) 726-3000

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

7629 Market St
Ste 200
Youngstown, OH 44512
Phone (330) 729-8000

250 Debartolo Pl
Ste 1200
Youngstown, OH 44512
Phone (234) 287-6440

Organizations & group practices 5

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.

Hospital & facility affiliations 10

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": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1659570448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 SOUTH AVE STE 2",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445123644",
            "telephone_number": "330-314-9140",
            "fax_number": "330-259-9721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 SOUTH AVE STE 2",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445123644",
            "telephone_number": "330-314-9140",
            "fax_number": "330-259-9721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMER",
        "first_name": "ANETA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2021-07-07",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.092671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0105995",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANETA",
            "last_name": "JEDRZEJCZYK",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boardman, OH

Sources for this page

Verify at the official NPI Registry.