Individual provider Active NPI

Anthony Peter Demetro, PA-C

  • Physician Assistant
  • Massillon, OH
National Provider Identifier
1760090807
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.007315RX Issued in OH
Practice address
2935 Lincoln Way NW
Massillon, OH 44647-5203
Phone
(330) 236-2300
NPI assigned
Jul 15, 2020
Last updated
Nov 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.007315RX OH Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

2935 Lincoln Way NW
Massillon, OH 44647-5203

Mailing address

6012 Ackley Rd
Parma, OH 44129-4602
Phone (330) 904-8334

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
I20220217002842 OH Practitioner - Physician Assistant 8224422126 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Urgent Care, LLCGroup PAC ID 3971985607, 109 clinicians

Practice addresses (Care Compare)

1634 Snow Rd
Parma, OH 44134-2719
Phone (440) 368-1520

2209 Crocker Rd
Suite D
Westlake, OH 44145-6727
Phone (440) 249-6060

36001 Euclid Ave
Unit 5
Willoughby, OH 44094-4643
Phone (440) 484-2160

3909 Orange PL
Suite 2100
Beachwood, OH 44122-8400
Phone (440) 809-8810

5901 E Royalton Rd
Suite 1400B
Broadview Heights, OH 44147-3532
Phone (440) 499-5900

6836 Ridge Rd
Parma, OH 44129-5627
Phone (216) 490-1120

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50.007315RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cleveland Clinic Mercy Hospital CurrentSince Dec 21, 2021 Accepting new patients
University Hospitals Urgent Care, LLC CurrentSince Feb 13, 2023 Accepting new patients
Cleveland Clinic Mercy Hospital CurrentSince Dec 21, 2021 Accepting new patients
University Primary Care Practices Inc CurrentSince Feb 13, 2023 Accepting new patients
University Primary Care Practices Inc CurrentSince Feb 13, 2023 Accepting new patients

Locations

3909 Orange Pl
Ste 2100
Beachwood, OH 44122
Phone (216) 896-1800

1330 Mercy Dr NW
Ste 200
Canton, OH 44708
Phone (330) 489-1000

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

2935 Lincoln Way NW
Massillon, OH 44647
Phone (330) 236-2285

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Interoperability endpoints

  • Direct secure messaging: ademetro593749@ehrdirect.uhhospitals.org

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": "1594771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1760090807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6012 ACKLEY RD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441294602",
            "telephone_number": "330-904-8334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2935 LINCOLN WAY NW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446475203",
            "telephone_number": "330-236-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMETRO",
        "first_name": "ANTHONY",
        "middle_name": "PETER",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-15",
        "last_updated": "2021-11-03",
        "certification_date": "2021-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.007315RX",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massillon, OH

Sources for this page

Verify at the official NPI Registry.