MR. JERRAMI LYDIC (ACNPC-AG) – Acute Care Nurse Practitioner, NPI 1912788092

MR. JERRAMI LYDIC (ACNPC-AG) is a healthcare provider. based in Youngstown, Ohio. specializing in NURSE PRACTITIONER. They hold the professional credentials ACNPC-AG. They hold a License No. RN716224 (PA). The NPI Number for MR. JERRAMI LYDIC (ACNPC-AG) is 1912788092

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
MR. JERRAMI LYDIC (ACNPC-AG)
NPI
1912788092
Phone
(330) 716-4380
Address
4935 HOPKINS RD
Enumeration Date
13 October 2023
Last Update Date
13 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3302970811
Graduation Year
2023 (3 years ago)
PAC ID
1759815863
Group Practice PAC ID
9739318635
Professional Enrollment ID
I20241112003981
Address ID
OH442663929RA6847XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:2State licenses:2Digital endpointsOther names

15,061 NURSE PRACTITIONER in OH

Provider Addresses for MR. JERRAMI LYDIC (ACNPC-AG)

  • 4935 HOPKINS RD

    YOUNGSTOWN, OH 445113623

    Phone: (330) 716-4380

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $15.

Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.

Last reported payment date: 2024-01-30 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($15).

Total Amount

$15

General + Research + Ownership

Payments

1

Total payment records

General Amount

$15

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-01-30

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-11-12

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241112003981INurse PractitionerOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44511)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9739318635View full group profile
NameSpecialtyState
Nurse PractitionerOH
-OH
Nurse PractitionerOH
-OH
Nurse PractitionerOH
Certified Clinical Nurse Specialist (Cns)OH

Reviews

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Frequently asked questions

Can I cross-check MR. JERRAMI LYDIC (ACNPC-AG) using NPI 1912788092?
NPI 1912788092 belongs to MR. JERRAMI LYDIC (ACNPC-AG); compare other details if you need extra assurance.
Is there an active status for MR. JERRAMI LYDIC (ACNPC-AG)?
For scheduling context, MR. JERRAMI LYDIC (ACNPC-AG) is shown as active in the registry.
What expertise is attributed to MR. JERRAMI LYDIC (ACNPC-AG)?
MR. JERRAMI LYDIC (ACNPC-AG)'s specialty line reads Acute Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is MR. JERRAMI LYDIC (ACNPC-AG) associated with Youngstown?
Public fields place MR. JERRAMI LYDIC (ACNPC-AG) around Youngstown, Ohio. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for MR. JERRAMI LYDIC (ACNPC-AG) is noted as October 13, 2023 where the registry provides it.

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