Individual provider Active NPI

Nicholas A Luisi, PA-C

  • Surgical Physician Assistant
  • Marion, OH
National Provider Identifier
1861749848
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
50.003554 Issued in OH
Practice address
1050 Delaware Ave
Marion, OH 43302-6416
Phone
(740) 375-6440
Fax
(740) 383-3040
NPI assigned
Aug 9, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 50.003554 OH Primary

Addresses

Primary practice location

1050 Delaware Ave
Marion, OH 43302-6416

Mailing address

5400 Frantz Rd
Suite 250
Dublin, OH 43016-4144

Other identifiers 1

IdentifierTypeStateIssuer
0076012MedicaidOH

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
I20130109000452 OH Practitioner - Physician Assistant 8628221272 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summa Physicians LLCGroup PAC ID 2961303532, 692 clinicians

Practice addresses (Care Compare)

155 5TH St NE
Barberton, OH 44203-3332

525 E Market St
Akron, OH 44304-1619

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.003554OHMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Summa Physicians LLC CurrentSince Oct 24, 2016 Accepting new patients
Ohiohealth Corporation CurrentSince Oct 28, 2012 Accepting new patients
Summa Physicians LLC Past Accepting new patients

Locations

525 E Market St
Akron, OH 44304
Phone (330) 375-6350

1077 Gorge Blvd
Akron, OH 44310
Phone (234) 312-5691

155 5th St NE
Barberton, OH 44203
Phone (330) 615-3000

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

5400 Frantz Rd
Ste 250
Dublin, OH 43016
Phone (614) 544-6161

1050 Delaware Ave
Marion, OH 43302
Phone (740) 383-7038

Interoperability endpoints

  • Direct secure messaging: nluisi19525@summahealth-direct.org

Organizations & group practices 5

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": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1861749848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 FRANTZ RD",
            "address_2": "SUITE 250",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430164144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 DELAWARE AVE",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026416",
            "telephone_number": "740-375-6440",
            "fax_number": "740-383-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUISI",
        "first_name": "NICHOLAS",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-09",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50.003554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0076012",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, OH

Sources for this page

Verify at the official NPI Registry.