Ernest A Dechellis, D.O.
Individual provider Active NPI Family Medicine Physician · Cortland, OH
NPI 1821040064 · NPPES record last updated Jul 28, 2016
Key facts
- NPI
- 1821040064
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 34004006 (OH)
- Practice address
- 3002 B Elmview Prof PK
State RT 5
Cortland, OH 44410-9202 - Phone
- (330) 637-1000
- Fax
- (330) 637-9905
- NPI assigned
- May 16, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Philadelphia College of Osteopathic Medicine, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
3002 State Route 5
Suite B
Cortland, OH 44410-9202
Phone (330) 637-1000
Hospital & facility affiliations
- MH St Joseph Warren Hospital
- MH St Elizabeth Youngstown Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111212000725 | OH | Practitioner - Family Practice | 7810162302 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34004006 | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| E. a. Dechellis, D.O., Inc. | Family Medicine | Current |
Accepting new patients |
Locations
3002 State Route 5
Ste B
Cortland, OH 44410
Phone (330) 637-1000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34004006 | OH | Yes |
Addresses
Primary practice location
3002 B Elmview Prof PK
State RT 5
Cortland, OH 44410-9202
Mailing address
3002 State Route 5
Ste B
Cortland, OH 44410-9202
Phone (330) 637-1000
Other providers in Cortland, OH
- Joe Cvengros
- Gregory Alan Davenport
- David L Harnett
- Leann Mahrie Davis
- Deborah Lee Davislindsey
- Andrea Dejacimo
- Dennis a. Benton, DDS, LLC
- Cindy Dickerson
- Franklin George Didado
- Kelly N Dillon
All providers in Cortland, OH · Family Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.