Individual provider Active NPI

Diana Brewster, DO

  • Family Medicine Physician
  • Canton, OH
National Provider Identifier
1992889851
Registry record updated Feb 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34007790 Issued in OH
Practice address
4172 Holiday St NW
Canton, OH 44718-2532
Phone
(330) 433-9260
Fax
(330) 433-9263
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34007790 OH Primary

Addresses

Primary practice location

4172 Holiday St NW
Canton, OH 44718-2532

Mailing address

4172 Holiday St NW
Canton, OH 44718-2532
Phone (330) 433-9260

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
I20041203000156 OH Practitioner - Family Practice 5597721373 Practice locations: Canton, OH

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio University, College of Osteopathic Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4172 Holiday NWST
Canton, OH 44718-2532
Phone (330) 433-9260

4172 Holiday St NW
Canton, OH 44718-2532

Hospital & facility affiliations

  • Aultman Hospital Hospital, Canton, OH, CCN 360084
  • Mercy Medical Center Hospital, Canton, OH, CCN 360070

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34007790OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kreptowski Family Practice LLC Family Medicine Current Accepting new patients
Integrated Pain Concepts LLC PastSince Oct 1, 2014 Accepting new patients
Beacon Medical, LLC PastSince Oct 1, 2014 Accepting new patients

Locations

6509 Frank Ave NW
North Canton, OH 44720
Phone (330) 244-0480

Interoperability endpoints

  • Direct secure messaging: admin@brewster.e-mdsdirect.com
  • FHIR API: https://api.platform.athenahealth.com/12074/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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 2

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550188800000",
    "number": "1992889851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4172 HOLIDAY ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182532",
            "telephone_number": "330-433-9260",
            "fax_number": "330-433-9263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4172 HOLIDAY ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182532",
            "telephone_number": "330-433-9260",
            "fax_number": "330-433-9263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWSTER",
        "first_name": "DIANA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34007790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.