| Pratheek Simon Kakkasseril, MD | |
|
1001 Belmont Ave, Youngstown, OH 44504-1003 | |
| (330) 747-1106 | |
| (330) 747-0491 |
| Full Name | Pratheek Simon Kakkasseril |
|---|---|
| Gender | Male |
| Speciality | Vascular Surgery |
| Experience | 20 Years |
| Location | 1001 Belmont Ave, Youngstown, Ohio |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609195643 | NPI | - | NPPES |
| 0078791 | Medicaid | OH | |
| H152570 | Other | OH | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2086S0129X | Surgery - Vascular Surgery | 35.120203 (Ohio) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Elizabeth Youngstown Hospital | Youngstown, OH | Hospital |
| Hmhp St Elizabeth Boardman Health Center | Boardman, OH | Hospital |
| Mh St Joseph Warren Hospital | Warren, OH | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mercy Health Physicians Youngstown Specialty Care Llc | 3476950296 | 388 |
| Ohio Wound Care Associates Llc | 7719393032 | 8 |
| Entity Name | Mercy Health Physicians Youngstown, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154636066 PECOS PAC ID: 9234318270 Enrollment ID: O20110124000753 |
| Entity Name | Ohio Wound Care Associates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659965457 PECOS PAC ID: 7719393032 Enrollment ID: O20210311002489 |
| Entity Name | Mercy Health Physicians Youngstown Specialty Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649892225 PECOS PAC ID: 3476950296 Enrollment ID: O20210921003835 |
| Mailing Address | Practice Location Address |
|---|---|
| Pratheek Simon Kakkasseril, MD 1001 Belmont Ave, Youngstown, OH 44504-1003 Ph: (330) 747-1106 | Pratheek Simon Kakkasseril, MD 1001 Belmont Ave, Youngstown, OH 44504-1003 Ph: (330) 747-1106 |
Dr. Breanne Gillie, MD Surgery Medicare: Medicare Enrolled Practice Location: 1044 Belmont Ave, Youngstown, OH 44504 Phone: 330-746-7211 | |
Michael R Sippel, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1001 Covington St, Youngstown, OH 44510 Phone: 330-480-2371 Fax: 330-480-3970 | |
Allison Mancuso, Surgery Medicare: Medicare Enrolled Practice Location: 1044 Belmont Ave Dept Of, Youngstown, OH 44504 Phone: 330-480-3752 | |
Tyler Robert Tominello, Surgery Medicare: Medicare Enrolled Practice Location: 1044 Belmont Ave, Youngstown, OH 44504 Phone: 330-480-3124 | |
Dr. James Robert Vienneau, DO Surgery Medicare: Not Enrolled in Medicare Practice Location: 1044 Belmont Ave, Youngstown, OH 44504 Phone: 330-480-3124 | |
Dr. Louis Sozon Lyras, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 7645 Market St Ste 200, Youngstown, OH 44512 Phone: 330-726-0156 Fax: 330-707-0618 | |
Mason Benchoff, DO Surgery Medicare: Not Enrolled in Medicare Practice Location: 1044 Belmont Ave, Youngstown, OH 44504 Phone: 717-387-0852 |