Individual provider Active NPI

Steven Joseph Humansky, PA-C

  • Medical Physician Assistant
  • Youngstown, OH
National Provider Identifier
1720426554
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
50.003742 Issued in OH
Practice address
1011 Boardman Canfield Rd
Youngstown, OH 44512-4226
Phone
(330) 629-2888
Fax
(330) 629-8940
NPI assigned
Jun 14, 2013
Last updated
Jul 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 50.003742 OH Primary
Medical Physician Assistant 363AM0700X MA056044 PA

Addresses

Primary practice location

1011 Boardman Canfield Rd
Youngstown, OH 44512-4226

Mailing address

1011 Boardman Canfield Rd
Youngstown, OH 44512-4226
Phone (330) 629-2888

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130628000394 OH Practitioner - Physician Assistant 2062652829 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio North East Health Systems IncGroup PAC ID 1951395086, shared by 9 NPIs, 34 clinicians

Practice addresses (Care Compare)

1977 Niles Rd SE
Warren, OH 44484-5118
Phone (330) 393-6446

716 Tod Ave SW
Warren, OH 44485-3608
Phone (330) 373-0222

726 Wick Ave
Youngstown, OH 44505-2827
Phone 330747955177182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.003742OHMDMedical Physician Assistant
MA056044PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Cyril Pain Clinic CurrentSince Sep 1, 2024 Accepting new patients

Locations

1621 E Market St
Ste A
Warren, OH 44483
Phone (330) 726-3800

1011 Boardman Canfield Rd
Youngstown, OH 44512
Phone 3306292888109

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437609600000",
    "number": "1720426554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 BOARDMAN CANFIELD RD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445124226",
            "telephone_number": "330-629-2888",
            "fax_number": "330-629-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 BOARDMAN CANFIELD RD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445124226",
            "telephone_number": "330-629-2888",
            "fax_number": "330-629-8940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMANSKY",
        "first_name": "STEVEN",
        "middle_name": "JOSEPH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-14",
        "last_updated": "2015-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.003742",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA056044",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.