NPIMap

Organization Active NPI

Mercy Health Youngstown LLC

Doing business as Mercy Health St Elizabeth Boardman Hospital

  • General Acute Care Hospital
  • Youngstown, OH
National Provider Identifier
1790868982
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
MERCY HEALTH YOUNGSTOWN LLC
Doing business as
Mercy Health St Elizabeth Boardman Hospital
St Elizabeth Boardman Hospital
Practice address
8401 Market St
Youngstown, OH 44512-6777
Phone
(330) 729-2929
Fax
(330) 729-1563
NPI assigned
Oct 23, 2006
Last updated
Jan 26, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Authorized official

Name
Kimberly M Ralston
Title
System Director
Phone
(419) 996-5119

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

8401 Market St
Youngstown, OH 44512-6777

Mailing address

PO Box 636469
Cincinnati, OH 45263-6469
Phone (330) 729-2929

Other names 2

  • MERCY HEALTH ST ELIZABETH BOARDMAN HOSPITAL Doing business as
  • St Elizabeth Boardman Hospital Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other BLUEMARK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070620000439 OH Part A Provider - Hospital 7517860489 Practice locations: Youngstown, OH; Warren, OH; Poland, OH; Boardman, OH; North Lima, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790868982. Details of each certification follow.

Hospital certification: CCN 360276

Legal name
MERCY HEALTH YOUNGSTOWN, LLC
Doing business as
MH ST ELIZABETH BOARDMAN HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Aug 9, 2007
Last certification
Aug 9, 2007
Beds
306
Ownership / control type
Church
Organization structure
LLCNon-profit
Incorporated
Mar 3, 1926 in OH
Enrollment address
8401 Market St
Youngstown, OH 44512-6725
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
HMHP St Elizabeth Boardman Health CenterCCN 360276 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D1085199St Elizabeth Boardman Hospital8401 Market Street, Boardman, OH 44512Certificate of waiverJun 11, 2028

National Provider Directory

National Provider Directory
Tax ID family
HM Health Services SE28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Locations

1932 Niles Cortland Rd NE
Ste H
Warren, OH 44484
Phone (330) 841-2386

1932 Niles Cortland Rd NE
Ste T
Warren, OH 44484
Phone (330) 856-1520

1001 Belmont Ave
Youngstown, OH 44504
Phone (330) 747-1106

8401 Market St
Youngstown, OH 44512
Phone (330) 729-2929

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Germaine G Bennett Individual Corporate DirectorBoard Member Jan 1, 2019
Martha Bushey Individual Corporate DirectorBoard Member Jan 1, 2025
Carla Baldwin Individual Corporate DirectorBoard Member Jan 1, 2026
Michelle Crawford Individual Corporate OfficerCfo Youngstown Jan 1, 2021
Corporate DirectorBoard Member Jan 1, 2021
W-2 Managing EmployeeCfo Youngstown Jan 1, 2021
Mildred Ely Individual Corporate DirectorBoard Member Feb 1, 2018
Joseph L Mosca Individual Corporate DirectorBoard Member Jan 1, 2020
Bon Secours Mercy Health Inc Organization, Blue Ash, OH Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Jan 1, 2020 100%
John Starcher Individual Operational/Managerial ControlCho Admin Jan 1, 2016
Lewis Macklin Individual Corporate DirectorBoard Member Feb 1, 2018
John Luellen Individual Corporate DirectorBoard Member Nov 14, 2018
Juan Santiago Individual Corporate DirectorBoard Member Jan 1, 2022
Rachel Hrbolich Individual Corporate DirectorBoard Member Jan 1, 2024
Jessica Simon Individual Corporate DirectorBoard Member Jan 1, 2023
Erin Bishop Individual Corporate DirectorBoard Member Jan 1, 2024
Edward Novosel Individual Corporate DirectorBoard Member Jan 1, 2020
Kimberly M Ralston Individual W-2 Managing EmployeeVP Reimbursement Oct 7, 2017

All facility ownership & control disclosures 12

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mercy Health Rehabilitation HospitalYoungstown, OH, CCN 363049 Hospital 5% Or Greater Direct Ownership Interest (50%) Nov 19, 2024
Bon Secours Home HealthRichmond, VA, CCN 497026C Home health agency 5% Or Greater Indirect Ownership Interest (14.24%) May 1, 2024
Mercy Health - Home Care PaducahPaducah, KY, CCN 187100 Home health agency 5% Or Greater Indirect Ownership Interest (14.24%) Apr 23, 2024
Mercy Health Home Health LimaLima, OH, CCN 367417 Home health agency 5% Or Greater Indirect Ownership Interest (14.24%) Apr 23, 2024
Mercy Health Home Care by CompassusTiffin, OH, CCN 367523 Home health agency 5% Or Greater Indirect Ownership Interest (14.24%) Apr 23, 2024
Mercy Health Home Care Lorain CountyLorain, OH, CCN 367218 Home health agency 5% Or Greater Indirect Ownership Interest (14.24%) Apr 23, 2024
Bon Secours Home Care by CompassusSun City Center, FL, CCN 109645 Home health agency 5% Or Greater Indirect Ownership Interest (14.24%) Jul 1, 2024
Bon Secours Hospice and Palliative CareRichmond, VA, CCN 491514 Hospice 5% Or Greater Indirect Ownership Interest (14.24%) May 1, 2024
Mercy Health - Hospice, LimaLima, OH, CCN 361543 Hospice 5% Or Greater Indirect Ownership Interest (14.24%) Apr 23, 2024
Mercy Health Hospice by CompassusMetropolis, IL, CCN 141548 Hospice 5% Or Greater Indirect Ownership Interest (14.24%) Apr 23, 2024
Mercy Health Home Care by CompassusLorain, OH, CCN 361563 Hospice 5% Or Greater Indirect Ownership Interest (15.29%) Apr 23, 2024
Mercy Health- Hospice PaducahPaducah, KY, CCN 181507 Hospice 5% Or Greater Indirect Ownership Interest (15.29%) Apr 23, 2024

Owned or controlled facilities with NPI records 13

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 13

Facilities with the same owner 97

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 97

Practitioners & affiliated clinicians

Practitioners 93

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 93

Affiliated clinicians 783

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 783

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643155200000",
    "number": "1790868982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636469",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636469",
            "telephone_number": "330-729-2929",
            "fax_number": "330-729-1563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 MARKET ST",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445126777",
            "telephone_number": "330-729-2929",
            "fax_number": "330-729-1563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH YOUNGSTOWN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A",
        "authorized_official_last_name": "RALSTON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR",
        "authorized_official_telephone_number": "419-996-5119"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.1",
            "affiliationName": "BLUEMARK",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "40 Sunset Ridge Rd Ste 120",
            "city": "New Paltz",
            "state": "NY",
            "country_code": "US",
            "postal_code": "125611039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MERCY HEALTH ST ELIZABETH BOARDMAN HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St Elizabeth Boardman Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St Elizabeth Boardman Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.