Individual provider Active NPI

Elizabeth Christine Stanovcak

  • Family Nurse Practitioner
  • Youngstown, OH
National Provider Identifier
1760006571
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
393972 Issued in OH
Practice address
650 S Meridian Rd
Youngstown, OH 44509-2932
Phone
(330) 792-7799
NPI assigned
Jun 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 393972 OH Primary

Addresses

Primary practice location

650 S Meridian Rd
Youngstown, OH 44509-2932

Mailing address

3752 Shields Rd
Canfield, OH 44406-8082
Phone (330) 398-8455

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL Youngstown Health Information Exchange (HIE)
Other URL Youngstown Health Information Exchange (HIE)

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
I20200709003142 OH Practitioner - Nurse Practitioner 8325461254 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
393972OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PA Post Acute Services PC CurrentSince Jan 21, 2024 Accepting new patients

Locations

7800 Jandaracres Dr
Cincinnati, OH 45248
Phone (513) 941-0787

8055 Addison Rd
Masury, OH 44438
Phone (330) 448-2547

2958 Canfield Rd
Youngstown, OH 44511
Phone (330) 792-5511

650 S Meridian Rd
Youngstown, OH 44509
Phone (330) 762-9341

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1760006571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3752 SHIELDS RD",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444068082",
            "telephone_number": "330-398-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 S MERIDIAN RD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445092932",
            "telephone_number": "330-792-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANOVCAK",
        "first_name": "ELIZABETH",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-08",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "393972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Youngstown",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "650 S Meridian Rd",
            "city": "Youngstown",
            "state": "OH",
            "country_code": "US",
            "postal_code": "445092932",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Youngstown",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "650 S Meridian Rd",
            "city": "Youngstown",
            "state": "OH",
            "country_code": "US",
            "postal_code": "445092932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.