TRACY L NEUENDORF (NPI# 1275509275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275509275 |
| Entity Type | Individual |
| Full Name | TRACY L NEUENDORF |
| Credential | D.O. |
| Practice Address |
1011 Boardman Canfield Rd Youngstown OH 44512-4226 |
| Practice Telephone | 3306292888 |
| Practice Fax Number | 3306298940 |
| Mailing Telephone | 3306292888 |
| Mailing Fax Number | 3306298940 |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2020-04-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207LA0401X |
Anesthesiology Specialization: Addiction Medicine |
34.003509 | OH | Allopathic & Osteopathic Physicians |
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
34-00-3509-N | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0601834 | 05 | |
| OH | ANTHEM | 127674 | 01 |
| OH | HIGHMARK BC/BS | 000403561 | 01 |
| PA | 0010273680005 | 05 |
| Street Address |
1011 BOARDMAN CANFIELD RD |
| City | YOUNGSTOWN |
| State | OH |
| Zip Code | 44512-4226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851367759 | Trinetta Dawn Masternick | Family Medicine | 1011 Boardman Canfield Rd, Youngstown, OH 44512-4226 | 2006-02-28 |
| 1780297945 | Peter Michael Hunkus IIi | Nurse Practitioner | 1011 Boardman Canfield Rd, Youngstown, OH 44512-4226 | 2020-08-27 |
| 1710473384 | Rachel Anne Carbon | Nurse Practitioner | 1011 Boardman Canfield Rd, Youngstown, OH 44512-4226 | 2018-07-07 |
| 1598135790 | Barbara A Walsh | Nurse Practitioner | 1011 Boardman Canfield Rd, Youngstown, OH 44512-4226 | 2015-09-30 |
| 1023406394 | Jason Sindledecker | Nurse Practitioner | 1011 Boardman Canfield Rd, Youngstown, OH 44512-4226 | 2015-01-08 |
| 1720426554 | Steven Joseph Humansky | Physician Assistant | 1011 Boardman Canfield Rd, Youngstown, OH 44512-4226 | 2013-06-14 |
| 1598048563 | Natalie G Kozicky | Nurse Practitioner | 1011 Boardman Canfield Rd, Youngstown, OH 44512-4226 | 2011-09-26 |
| 1245518125 | Jafri Mohammed Syed | Anesthesiology | 1011 Boardman Canfield Rd, Youngstown, OH 44512-4226 | 2011-07-27 |
| 1427374735 | Linda Garea | Registered Nurse | 1011 Boardman Canfield Rd, Youngstown, OH 44512-4226 | 2010-04-12 |
| 1730327511 | Krista J. Wasser | Counselor | 1011 Boardman Canfield Rd, Youngstown, OH 44512-4226 | 2009-02-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285248740 | Kimberly Vrabel | Counselor | 725 Boardman Canfield Road Road Unit 1 and Unit 2, Boardman, OH 44512 | 2020-09-02 |
| 1043830144 | Steffi Lorraine D'souza | Student in an Organized Health Care Education/Training Program | 8423 Market Street Suite 101 St. Elizabeth Boardman Hos, Boardman, OH 44512 | 2020-04-20 |
| 1427677830 | Shivani Sharma | Family Medicine | 8423 Market Street Suite 101, St Elizabeth Boardman Hospital, Boardman, OH 44512 | 2020-04-15 |
| 1417587825 | Ronny Zetts | Pharmacist | 308 Boardman-canfield Rd, Boardman, OH 44512 | 2020-01-24 |
| 1285105080 | Andrew Dawson | Nurse Practitioner | 883 Boardman Canfield Rd Ste 105, Youngstown, OH 44512 | 2018-12-06 |
| 1700374949 | Adam Leid | Student in an Organized Health Care Education/Training Program | St Elizabeth Boardman Hospital - Medical Education Dept, 8401 Market Street, Boardman, OH 44512 | 2018-04-24 |
| 1528574910 | Herman Frank IIi | Licensed Practical Nurse | 920 Boardman Canfield Road, Boardman, OH 44512 | 2017-12-20 |
| 1730601980 | Stephanie Ann Mathews | Nurse Practitioner | 7600 Southern Blvd #1, Boardman, OH 44512 | 2017-07-10 |
| 1417485079 | Telka Ghobadi | Family Medicine | 8423 Market St., Suite 101, Boardman, OH 44512 | 2017-05-26 |
| 1356797534 | Haroon Hussain Syed | Student in an Organized Health Care Education/Training Program | 8423 Market Street, St. Elizabeth Boardman Hospital, Boardman, OH 44512 | 2016-05-06 |
| Find all providers in zip 44512 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437544905 | Lucas Mark Davanzo | Anesthesiology | 7630 Southern Blvd, Youngstown, OH 44512-5633 | 2015-04-01 |
| 1366709602 | Joseph Williams | Anesthesiology | 7630 Southern Blvd, Youngstown, OH 44512-5633 | 2012-04-11 |
| 1245518125 | Jafri Mohammed Syed | Anesthesiology | 1011 Boardman Canfield Rd, Youngstown, OH 44512-4226 | 2011-07-27 |
| 1215118658 | Mahoning Anesthesia Consultants, LLC | Anesthesiology | 7067 Tiffany Blvd, Suite 230, Youngstown, OH 44514-1993 | 2007-11-14 |
| 1265650949 | Southwoods Anesthesia, LLC | Anesthesiology | 7630 Southern Blvd, Youngstown, OH 44512-5633 | 2007-04-20 |
| 1861560039 | Martin Joseph Grennan Jr. | Anesthesiology | 1044 Belmont Ave, Youngstown, OH 44504-1006 | 2006-12-04 |
| 1841240116 | Mike G Corfias | Anesthesiology | 7600 Southern Blvd, Suite 1, Youngstown, OH 44512-5633 | 2006-05-10 |
| 1649238072 | Shawn Michael Donatelli | Anesthesiology | 7067 Tiffany Blvd, Suite 230, Youngstown, OH 44514-1993 | 2006-05-03 |
| 1982699021 | Anjum Iqbal | Anesthesiology | 3622 Belmont Ave, Suite 1, Youngstown, OH 44505-1450 | 2005-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295347706 | Adeeb Oweidat | Anesthesiology | 1999 Circle Drive Centric, Apartment 417, Cleveland, OH 44106 | 2020-08-18 |
| 1558749770 | Mackenzie Pullee | Anesthesiology | 634 Sycamore St, Cincinnati, OH 45202-2535 | 2015-05-07 |
| 1366869380 | Pyramid Physician Services LLC | Anesthesiology | 2680 Indian Ripple Rd, Beavercreek, OH 45440-3605 | 2014-03-27 |
| 1790126084 | Hurricane Pain Management LLC | Anesthesiology | 174 Lake Bluff Dr, Columbus, OH 43235-4671 | 2013-07-15 |
| 1417218926 | Andrew Bernard Collins | Anesthesiology | 3333 Burnet Ave # Mlc4009, Cincinnati, OH 45229-3026 | 2012-05-31 |
| 1518259597 | Arion Alexander Smalley | Anesthesiology | 7759 University Dr Ste C, West Chester, OH 45069-6578 | 2011-05-09 |
| 1144529793 | Adil O. Katabay, Md, LLC | Anesthesiology | 4967 Silverton Way, Dublin, OH 43016-7443 | 2011-03-22 |
| 1568788909 | Lucasville Medical Specialist | Anesthesiology | 10940 State Route 104, Lucasville, OH 45648-8495 | 2010-04-09 |
| 1043464951 | Brandon Harris | Anesthesiology | 4881 Sugar Maple Dr # Drivea, Wright Pat, OH 45433-5529 | 2008-11-06 |
| 1598930711 | James Christopher Kelly | Anesthesiology | 222 N 5th St Ste 202, Martins Ferry, OH 43935-1582 | 2008-04-29 |
| Find all providers with the same taxonomy | ||||
| City | YOUNGSTOWN |
| Zip Code | 44512 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.