Vida S Kaniecki, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35.134780 Issued in OH

Practice address

6505 Market St BLDG A1
Youngstown, OH 44512-3457

Phone

(330) 746-8040

Fax

(330) 746-8025

NPI assigned

May 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Children'S Hospital Medical Center of Akron

  • Pediatrics Physician
  • Akron, OH
  • NPI 1841328853
  Medicare reassignment NPD
• Akron Children'S Hospital

  • Children's Hospital
  • Akron, OH
  • NPI 1942465752
  NPD
• Children'S Hospital Medical Center of Akron

  • Anesthesiology Physician
  • Boardman, OH
  • NPI 1417257601
  NPD
• Children'S Hospital Medical Center of Akron

  • Home Infusion Agency
  • Akron, OH
  • NPI 1649485848
  NPD
• Mercy Health Youngstown LLC

  • General Acute Care Hospital
  • Youngstown, OH
  • NPI 1790868982
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1730131723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6505 MARKET ST BLDG A1",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445123457",
            "telephone_number": "330-746-8040",
            "fax_number": "330-746-8025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6505 MARKET ST BLDG A1",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445123457",
            "telephone_number": "330-746-8040",
            "fax_number": "330-746-8025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANIECKI",
        "first_name": "VIDA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.134780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012772440001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "198726H87",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1730131723",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vkaniecki92199@direct.chmca.org",
            "affiliation": "N",
            "address_1": "6505 Market St Bldg A1",
            "city": "Youngstown",
            "state": "OH",
            "country_code": "US",
            "postal_code": "445123457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Emilia Ilyichna Kalutskaya, MD
• Abby Elizabeth Kampfer, DPT
• Linda May Kanche, RN
• Kimothy A Kane, CNP
• Mike Kane, COUNSELOR TRAINEE
• Amanda L. Kantaras, LPCC-S
• Brent Scott Kantaras, M.ED., PCC
• Yelena Leah Kaplan, DPM
• Michelle Kapon, MD
• Brittany Dawn Kapp, RBT

• Pediatrics Physician in Youngstown, OH
• Providers in Youngstown, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.