NPIMap

Individual provider Active NPI

Tedmund R Mason, PAC

  • Physician Assistant
  • Boardman, OH
National Provider Identifier
1912158577
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.002794 Issued in OH
Practice address
1499 Boardman Canfield Rd
Boardman, OH 44512-4008
Phone
(330) 758-0577
NPI assigned
Oct 1, 2008
Last updated
Apr 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.002794 OH Primary

Addresses

Primary practice location

1499 Boardman Canfield Rd
Boardman, OH 44512-4008

Mailing address

8591 Crossroad Dr
Youngstown, OH 44514-4382
Phone (330) 758-0577

Other practice location 1

1695 Niles Cortland Rd NE
Warren, OH 44484-1165
Phone (330) 758-0577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090219000126 OH Practitioner - Physician Assistant 2062577463 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quick Med Urgent Care LLCGroup PAC ID 5799016358, 49 clinicians

Practice addresses (Care Compare)

120 N Lincoln Ave
Salem, OH 44460-2904
Phone (234) 320-7770

15 Boardman Canfield Rd
Suite 4
Boardman, OH 44512-4541
Phone (330) 333-4200

3499 Belmont Ave
Youngstown, OH 44505-1807
Phone (330) 759-0085

4990 Mahoning Ave
Austintown, OH 44515-1757
Phone (330) 992-4100

Merit-based Incentive Payment System (MIPS)

Final score
70.01 of 100Reported as group
Quality
64.72
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
76.8 of 100Reported as group
Quality
69.32
Improvement activities
40
Cost
78.93

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.002794OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southwoods Health at Home, LLC PastSince Sep 1, 2021 Accepting new patients
Youngstown Orthopaedic Associates LTD Past Accepting new patients
The Surgery Center at Southwoods, LLC Past Accepting new patients
Children's Hospital Medical Center of Akron Past Accepting new patients
Youngstown Orthopaedic Associates LTD PastSince Apr 21, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tedmund.mason.1@19801.direct.athenahealth.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1912158577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8591 CROSSROAD DR",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445144382",
            "telephone_number": "330-758-0577",
            "fax_number": "330-758-0466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1499 BOARDMAN CANFIELD RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124008",
            "telephone_number": "330-758-0577"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1695 Niles Cortland Rd NE",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "OH",
            "postal_code": "444841165",
            "country_code": "US",
            "telephone_number": "330-758-0577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASON",
        "first_name": "TEDMUND",
        "middle_name": "R",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-01",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.002794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

Verify at the official NPI Registry.