Individual provider Active NPI

Suzanne Elise Maddamma, MD

  • Hospitalist Physician
  • Youngstown, OH
National Provider Identifier
1851920656
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
35.146074 Issued in OH
Practice address
1044 Belmont Ave
Youngstown, OH 44504-1006
Phone
(330) 480-7320
Fax
(330) 729-1591
NPI assigned
Apr 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 57.249455 OH
Hospitalist Physician 208M00000X 35.146074 OH Primary

Addresses

Primary practice location

1044 Belmont Ave
Youngstown, OH 44504-1006

Mailing address

1044 Belmont Ave
Youngstown, OH 44504-1006
Phone (330) 480-7320

Other practice location 1

8401 Market St
Boardman, OH 44512-6725
Phone (330) 729-4298

Other practice location 2

667 Eastland Ave SE
Warren, OH 44484-4503
Phone (330) 841-2378

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230811003405 OH Practitioner - Internal MedicinePractitioner - Hospitalist 7719300136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Youngstown Specialty Care LLCGroup PAC ID 3476950296, 463 clinicians

Practice addresses (Care Compare)

1044 Belmont Ave
Youngstown, OH 44504-1006
Phone (330) 480-3655

Hospital & facility affiliations

  • MH St Elizabeth Youngstown Hospital Hospital, Youngstown, OH, CCN 360064
  • HMHP St Elizabeth Boardman Health Center Hospital, Boardman, OH, CCN 360276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.146074OHMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jul 1, 2023 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC Hospitalist CurrentSince Jul 1, 2023 Accepting new patients
Mercy Health Youngstown LLC Past Accepting new patients
Mercy Health Youngstown LLC Past Accepting new patients

Locations

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

667 Eastland Ave SE
Warren, OH 44484
Phone (330) 841-2378

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

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

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1851920656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041006",
            "telephone_number": "330-480-7320",
            "fax_number": "330-729-1591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041006",
            "telephone_number": "330-480-7320",
            "fax_number": "330-729-1591"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8401 Market St",
            "address_purpose": "LOCATION",
            "city": "Boardman",
            "state": "OH",
            "postal_code": "445126725",
            "country_code": "US",
            "telephone_number": "330-729-4298",
            "fax_number": "330-729-1591",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "667 Eastland Ave SE",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "OH",
            "postal_code": "444844503",
            "country_code": "US",
            "telephone_number": "330-841-2378",
            "fax_number": "330-729-1591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADDAMMA",
        "first_name": "SUZANNE",
        "middle_name": "ELISE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57.249455",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35.146074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.