Individual provider Active NPI

Joseph Burton Masternick, D.O.

  • Family Medicine Physician
  • Boardman, OH
National Provider Identifier
1669491569
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34.002093 Issued in OH
Practice address
914 Trailwood Dr
Boardman, OH 44512-5007
Phone
(330) 758-4568
Fax
(330) 758-5683
NPI assigned
Jul 19, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34.002093 OH Primary

Addresses

Primary practice location

914 Trailwood Dr
Boardman, OH 44512-5007

Mailing address

P.O. Box 14290
Poland, OH 44514
Phone (330) 758-4568

Other identifiers 2

IdentifierTypeStateIssuer
0273985MedicaidOH
000000128887OtherOHANTHEM

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
I20040308001050 OH Practitioner - Family PracticePractitioner - General PracticePractitioner - Sports MedicinePractitioner - Physical Medicine and Rehabilitation 1658269089 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City College of Medicine and Surgery, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Addiction Outreach Clinic LTDGroup PAC ID 5294183893, 11 clinicians

Practice addresses (Care Compare)

5250 Windsor Way
New Middletown, OH 44442-7746
Phone (330) 542-9542

819 McKay CT
Suite 102
Boardman, OH 44512-5771
Phone (330) 259-4849

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2093OHMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Addiction Outreach Clinic LTD CurrentSince Nov 1, 2023 Accepting new patients
Pinnacle Integrated Health, LLC CurrentSince Jun 1, 2016 Accepting new patients
Joseph B Masternick DO Inc CurrentSince Feb 17, 2010 Accepting new patients
Physicians Diagnostic & Rehabilitation Center Inc Past Accepting new patients
Omni Manor, Inc. Past Accepting new patients
Prima Health Care LLC Past Accepting new patients

Locations

184 Currie Hall Pkwy
Ste 2
Kent, OH 44240
Phone (330) 967-8077

5250 Windsor Way
New Middletwn, OH 44442
Phone (330) 518-8676

5342 Meadow Lane Ct
Sheffield Village, OH 44035
Phone (440) 934-2200

819 McKay Ct
Ste 101
Youngstown, OH 44512
Phone (330) 726-7100

819 McKay Ct
Ste 102
Youngstown, OH 44512
Phone (330) 259-4849

914 Trailwood Dr
Youngstown, OH 44512
Phone (330) 758-4568

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Masternick Memorial Health Care CenterNew Middletown, OH, CCN 366375 Skilled nursing facility Adp of the SNF Jul 20, 2009

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 4

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669491569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 14290",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "44514",
            "telephone_number": "330-758-4568",
            "fax_number": "330-758-5683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 TRAILWOOD DR",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445125007",
            "telephone_number": "330-758-4568",
            "fax_number": "330-758-5683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTERNICK",
        "first_name": "JOSEPH",
        "middle_name": "BURTON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.002093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0273985",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000128887",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

Verify at the official NPI Registry.