Steven Joseph Humansky, PA-C
Individual provider Active NPI Medical Physician Assistant · Youngstown, OH
NPI 1720426554 · NPPES record last updated Jul 23, 2015
Key facts
- NPI
- 1720426554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 50.003742 (OH)
- Practice address
- 1011 Boardman Canfield Rd
Youngstown, OH 44512-4226 - Phone
- (330) 629-2888
- Fax
- (330) 629-8940
- NPI assigned
- Jun 14, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ohio North East Health Systems Inc
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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130628000394 | OH | Practitioner - Physician Assistant | 2062652829 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA056044 | PA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Cyril Pain Clinic Inc | Current |
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 50.003742 | OH | Yes |
| 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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 55837 | Medicaid | OH |
NPI Registry JSON
{
"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": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "55837",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Youngstown, OH
- Kimberly Louise Hughley
- Victoria Nicole Hughley
- Da'Veon Hugley
- Larisa Katherine Hull
- Mallori Lynn Hull
- Alisa Humbert
- Elliot Donnell Humbert
- George E Humes
- Roshawnda Rochelle Humphrey
- Amber Hunkus
All providers in Youngstown, OH · Medical Physician Assistant in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.