| Michele Elizabeth Petruccelli, | |
|
36100 Euclid Avenue, Suite 240, Willoughby, OH 44094 | |
| (440) 953-6294 | |
| (440) 918-4687 |
| Full Name | Michele Elizabeth Petruccelli |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 10 Years |
| Location | 36100 Euclid Avenue, Willoughby, Ohio |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538521000 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | COA18962-NP (Ohio) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Northern Ohio Medical Specialists, Llc | 2769386192 | 276 |
| Entity Name | Northern Ohio Medical Specialists, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225085855 PECOS PAC ID: 2769386192 Enrollment ID: O20031126000214 |
| Entity Name | Lake Hospital System, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952339996 PECOS PAC ID: 6002713922 Enrollment ID: O20031217000963 |
| Mailing Address | Practice Location Address |
|---|---|
| Michele Elizabeth Petruccelli, 1246 Mohegan Trl, Willoughby, OH 44094-7310 Ph: (440) 220-0015 | Michele Elizabeth Petruccelli, 36100 Euclid Avenue, Suite 240, Willoughby, OH 44094 Ph: (440) 953-6294 |
Samantha C Cole, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6005 Som Center Rd, Willoughby, OH 44094 Phone: 866-389-2727 | |
Robert William Jonath, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 36000 Euclid Avenue, Willoughby, OH 44094 Phone: 440-953-9600 | |
Kimberly Vanik, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 35717 Euclid Ave, Willoughby, OH 44094 Phone: 440-449-1540 | |
Ashley King, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1601 Arbor Dr, Willoughby, OH 44094 Phone: 440-339-0218 | |
Shanon Lee Mekesa Ellis, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6005 Som Center Rd, Willoughby, OH 44094 Phone: 440-946-7252 | |
Alexandria Uher, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 35717 Euclid Ave, Willoughby, OH 44094 Phone: 440-449-1540 | |
Jaquina Ross, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 35900 Euclid Ave, Willoughby, OH 44094 Phone: 440-953-3000 |