Edmund Louis Wymyslo Jr., M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35058808W Issued in OH

Practice address

4860 Frank Rd NW
North Canton, OH 44720-7426

Phone

(330) 494-7099

Fax

(330) 494-2147

NPI assigned

Feb 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

Medical College of Ohio, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Physicians IncGroup PAC ID 9436176799, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aultman Health Care in Your Home Home health agency, Canton, OH, CCN 367290
• Aultman Hospital Hospital, Canton, OH, CCN 360084

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ewymyslo@fpi-oh.direct.office.nextgen.com
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Family Physicians Inc

  • Family Medicine Physician
  • North Canton, OH
  • NPI 1578537825
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Aultman Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1356366991
  Care Compare affiliation
• Aultman Hospital

  • Home Health Agency
  • Canton, OH
  • NPI 1669568564
  Care Compare affiliation

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1922072024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4860 FRANK RD NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207426",
            "telephone_number": "330-494-7099",
            "fax_number": "330-494-2147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4860 FRANK RD NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207426",
            "telephone_number": "330-494-7099",
            "fax_number": "330-494-2147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYMYSLO",
        "first_name": "EDMUND",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35058808W",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0838713",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kira L Wrieth, LPTA
• Courtney Marie Wright, RD, LD, CPT
• Susan Writz, COTA/L
• Veronica Wulw, PTA
• Amber R Wurm, LPTA
• X-Excel LTD
• Carolyn Xu, PTA
• Shakhnoza Yagfarova
• Jessica Leigh Yagiela, MSN, APRN, NP-C
• Rachel T Yagour, SLP

• Family Medicine Physician in North Canton, OH
• Providers in North Canton, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.