PRATHEEK SIMON KAKKASSERIL (NPI# 1609195643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609195643 |
| Entity Type | Individual |
| Full Name | PRATHEEK SIMON KAKKASSERIL |
| Credential | M.D. |
| Practice Address |
1001 Belmont Ave Youngstown OH 44504-1003 |
| Practice Telephone | 3307471106 |
| Practice Fax Number | 3307470491 |
| Mailing Telephone | 3307471106 |
| Mailing Fax Number | 3307470491 |
| Enumeration Date | 2010-05-28 |
| Last Update Date | 2020-02-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
35.120203 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0078791 | 05 | |
| OH | MEDICARE PTAN | H152570 | 01 |
| Street Address |
1001 BELMONT AVE |
| City | YOUNGSTOWN |
| State | OH |
| Zip Code | 44504-1003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497725188 | Jocelyn Rae Kimmel | Physician Assistant | 1001 Belmont Ave, Youngstown, OH 44504-1003 | 2006-01-25 |
| 1598249765 | Victoria Danielle Puckett | Physician Assistant | 1001 Belmont Ave, Youngstown, OH 44504-1003 | 2018-09-24 |
| 1497274054 | Kaitlyn E Buxman | Emergency Medicine | 1001 Belmont Ave, Youngstown, OH 44504-1003 | 2017-09-14 |
| 1700308392 | Brittany Lynne Mihaly | Physician Assistant | 1001 Belmont Ave, Youngstown, OH 44504-1003 | 2017-07-14 |
| 1669855615 | Larissa Ann Roth | Nurse Practitioner | 1001 Belmont Ave, Youngstown, OH 44504-1003 | 2015-07-08 |
| 1598006223 | Brenda Sue Ginder | Nurse Practitioner | 1001 Belmont Ave, Youngstown, OH 44504-1003 | 2013-03-05 |
| 1992071880 | Rami Kafa | Internal Medicine | 1001 Belmont Ave, Youngstown, OH 44504-1003 | 2012-03-26 |
| 1144515644 | Linda Russell | Clinical Nurse Specialist | 1001 Belmont Ave, Youngstown, OH 44504-1003 | 2011-06-13 |
| 1821382953 | Annette Danielle Hinrichs | Clinical Nurse Specialist | 1001 Belmont Ave, Youngstown, OH 44504-1003 | 2011-06-07 |
| 1356659338 | Lucas W Henn | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1001 Belmont Ave, Youngstown, OH 44504-1003 | 2010-09-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003458845 | Shay Kahani | Social Worker | 517 Gypsy Lane, Youngstown, OH 44504 | 2019-10-14 |
| 1497312573 | Parth Shah | Student in an Organized Health Care Education/Training Program | Western Reserve Health Education, 500 Gypsy Lane, Medical Office Building A, Youngstown, OH 44504 | 2019-05-23 |
| 1811455348 | Kisha Brady | Nurse Practitioner | 1350 Belmont Ave, Youngstown, OH 44504 | 2019-03-04 |
| 1750808473 | Janae White | Home Health | 2278 Cordova Ave, Youngstown, OH 44504 | 2017-08-23 |
| 1760910509 | Ryan Gallagher | Student in an Organized Health Care Education/Training Program | 1001 Covington Ave, Youngstown, OH 44504 | 2017-05-24 |
| 1649727314 | Bilal Abo Almakarim Kanawati | Specialist/Technologist, Other | 461 Gypsy Ln Apt 72, Youngstown, OH 44504 | 2016-09-09 |
| 1174979157 | Hiyam Abdelmagid | Internal Medicine | 1001 Covington Ave., Youngstown, OH 44504 | 2016-05-10 |
| 1962696419 | Earnest Perry, M.d., Inc. | Surgery | 1320 Belmont Avenue, Ste 2, Youngstonw, OH 44504 | 2007-08-28 |
| 1699839738 | Rodney Earl Hill | Family Medicine | 1350 Fifth Ave, Suite 324, Youngstown, OH 44504 | 2006-12-21 |
| 1710063987 | David A Hoffman | Internal Medicine | 1220 Belmont Avenue, Youngstown, OH 44504 | 2006-10-31 |
| Find all providers in zip 44504 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922033901 | Michael Samuel Cicchillo | Surgery | 540 Parmalee Ave Ste 410, Youngstown, OH 44510-1605 | 2006-07-11 |
| 1467633149 | Mahoning Valley Wound Care, Inc. | Surgery | 540 Parmalee Ave, Suite 610, Youngstown, OH 44510-1716 | 2007-11-21 |
| 1497722375 | Venkata S. K. Kollipara | Surgery | 1001 Belmont Ave, Youngstown, OH 44504-1003 | 2006-03-01 |
| 1649247529 | Jason Richard Delatore | Surgery | 540 Parmalee Ave, 410, Youngstown, OH 44510-1716 | 2006-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659993459 | Matt Thompson | Surgery | Department of Vascular Surgery 9500 Euclid Avenue, Cleveland, OH 44195-0001 | 2020-05-14 |
| 1194373704 | Premier Vein and Vascular Care LLC | Surgery | 33290 Bainbridge Rd, Solon, OH 44139-2802 | 2019-08-27 |
| 1588144299 | Garcia Vascular Surgery Center, LLC | Surgery | 29099 Health Campus Dr Ste 380, Westlake, OH 44145-5276 | 2018-08-21 |
| 1962900365 | Marilyn Mcnamara | Surgery | 1031 Brook Ln, Rocky River, OH 44116-2184 | 2018-01-31 |
| 1386155521 | Zanesville Vascular Vein & Wound Center LLC | Surgery | 3964 Frazeysburg Rd Unit A, Zanesville, OH 43701-8920 | 2017-10-16 |
| 1679026751 | Center for Vein Restoration Oh, LLC | Surgery | 1050 Isaac Streets Dr Ste 131, Oregon, OH 43616-8203 | 2016-07-26 |
| 1235541640 | Jon Garrett Quatromoni | Surgery | Mail Code F30 9500 Euclid Avenue, Cleveland, OH 44195-4238 | 2014-05-20 |
| 1881035343 | Innovative Wound Care Associates, Inc | Surgery | 790 Boardman Canfield Rd Ste 3, Boardman, OH 44512-4344 | 2013-07-12 |
| 1184062242 | Jorge Enrique Motta | Surgery | 12268 Church Rd, Orrville, OH 44667-9623 | 2013-06-11 |
| 1912245853 | Cleveland East Vascular Care, LLC | Surgery | 23650 Commerce Park Ste B, Beachwood, OH 44122-5817 | 2013-01-28 |
| Find all providers with the same taxonomy | ||||
| City | YOUNGSTOWN |
| Zip Code | 44504 |
Please comment or provide details below to improve the information on PRATHEEK SIMON KAKKASSERIL.
| 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.