Individual provider Active NPI

Frank A Luckino III, DPM

  • Foot & Ankle Surgery Podiatrist
  • Youngstown, OH
National Provider Identifier
1801187570
Registry record updated Mar 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
36-3689 Issued in OH
Practice address
8175 Market St
Apt. 1B
Youngstown, OH 44512-6244
Phone
(330) 629-8800
NPI assigned
Apr 28, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 36-3689 OH Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

8175 Market St
Apt. 1B
Youngstown, OH 44512-6244

Mailing address

128 Wertz Ave NW Ste #a
Canton, OH 44708
Phone (330) 477-6265

Other identifiers 1

IdentifierTypeStateIssuer
0107688MedicaidOH

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140611001845 OH Practitioner - Podiatry 1557585676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4900 Frank Ave NW
Suite 102
Canton, OH 44720-7483
Phone (330) 477-6265

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue235
Removal of skin lesions1-10
Removal of nail tissue523
Removal or shaving of skin growth187

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36-3689OHMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Ohio Foot and Ankle Specialists LLC Foot & Ankle Surgery CurrentSince Sep 1, 2017 Accepting new patients

Locations

128 Wertz Ave NW
Ste A
Canton, OH 44708
Phone (330) 453-7339

4900 Frank Ave NW
Ste 102
North Canton, OH 44720
Phone (330) 477-6265

4900 Frank Ave NW
North Canton, OH 44720
Phone (330) 494-9797

Organizations & group practices 1

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 2

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": "1303948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553817600000",
    "number": "1801187570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 WERTZ AVE NW STE #A",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44708",
            "telephone_number": "330-477-6265",
            "fax_number": "330-477-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8175 MARKET ST",
            "address_2": "APT. 1B",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445126244",
            "telephone_number": "330-629-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKINO",
        "first_name": "FRANK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-28",
        "last_updated": "2019-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36-3689",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0107688",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.