Addie Shock, - Medicare Nurse Practitioner in Elyria, OH

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Addie Shock, is a medicare enrolled "Nurse Practitioner - Pediatrics" in Elyria, Ohio. Her current practice location is 125 E Broad St Ste 302, Elyria, Ohio. You can reach out to her office (for appointments etc.) via phone at (440) 323-0258.

Addie Shock is licensed to practice in Ohio (license number RN3810151) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1215380423.

Contact Information

Addie Shock,
125 E Broad St Ste 302,
Elyria, OH 44035-6447
(440) 323-0258
Not Available

Map and Direction




Provider's Profile

Full NameAddie Shock
GenderFemale
SpecialityNurse Practitioner - Pediatrics
Location125 E Broad St Ste 302, Elyria, Ohio
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1215380423
  • Provider Enumeration Date: 07/22/2016
  • Last Update Date: 03/29/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 5294002762
  • Enrollment ID: I20170605001649

Medical Identifiers

Medical identifiers for Addie Shock such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1215380423NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0200XNurse Practitioner - Pediatrics RN3810151 (Ohio)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Addie Shock allows following entities to bill medicare on her behalf.
Entity NameThe Cleveland Clinic Foundation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1679525919
PECOS PAC ID: 1850203555
Enrollment ID: O20031103000049
Entity NameLorain County Health & Dentistry
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1215194527
PECOS PAC ID: 9234047853
Enrollment ID: O20031105000774

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Addie Shock is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Addie Shock,
9807 Nicole Ln,
Olmsted Twp, OH 44138-4252

Ph: (419) 685-4353		Addie Shock,
125 E Broad St Ste 302,
Elyria, OH 44035-6447

Ph: (440) 323-0258

Reviews and Comments


Nurse Practitioner Nurses in Elyria, OH

Bretzyl M Liscoe,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 630 E River St, Elyria, OH 44035
Phone: 440-323-8515    
Nicole Fatemeh Scavuzzo, CNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 525 Chestnut Commons Dr, Elyria, OH 44035
Phone: 440-406-8153    Fax: 440-406-8312
Mary Lauretta Gilchrist,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 630 E River St, Elyria, OH 44035
Phone: 440-329-7500    
Ms. Amy M. King, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 630 E River St, Elyria, OH 44035
Phone: 440-329-7500    
Amy M Kovalsky, RN, CNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 630 E River St, Elyria, OH 44035
Phone: 440-329-7500    
Mrs. Brenda J Life, CNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 125 E Broad St, Suite 305, Elyria, OH 44035
Phone: 440-326-4120    Fax: 440-322-3454
Jennifer Gelske, CNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 41201 Schadden Rd, Elyria, OH 44035
Phone: 440-324-0400    Fax: 440-324-0441

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.