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9110 Mentor Ave Unit 9b Mentor OH 44060-6404 | |
| (440) 701-8030 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 9110 Mentor Ave Unit 9b, Mentor, Ohio |
| Authorized Official Name and Position | Ganga Venuthurla (OWNER) |
| Authorized Official Contact | 4407018030 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 10417 Holyoke MA 01041-2017 Ph: () - | 9110 Mentor Ave Unit 9b Mentor OH 44060-6404 Ph: (440) 701-8030 |
| NPI Number | 1811508625 |
|---|---|
| Provider Enumeration Date | 08/14/2020 |
| Last Update Date | 11/22/2021 |
| Medicare PECOS PAC ID | 7012337629 |
|---|---|
| Medicare Enrollment ID | O20201021000825 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811508625 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | Laxman R Cingireddi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184640732 PECOS PAC ID: 1254336662 Enrollment ID: I20060918000482 |
| Provider Name | Kristin L Mcnabb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760761290 PECOS PAC ID: 3678748605 Enrollment ID: I20111202000419 |
| Provider Name | Courtney B Gravens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467766261 PECOS PAC ID: 8729205653 Enrollment ID: I20140815001806 |
| Provider Name | Natalie A Kolman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063894681 PECOS PAC ID: 2062724388 Enrollment ID: I20150630000098 |
| Provider Name | Allison J Megyesi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306216502 PECOS PAC ID: 7618286873 Enrollment ID: I20160712003216 |
| Provider Name | Svetlana M Higgins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730664707 PECOS PAC ID: 2567715998 Enrollment ID: I20181031002686 |
| Provider Name | James Robert Schroeder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104380328 PECOS PAC ID: 5294161824 Enrollment ID: I20200130001019 |
| Provider Name | Alayna Mechelle Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194924050 PECOS PAC ID: 5799190807 Enrollment ID: I20210224000268 |
| Provider Name | Kristen Leah Smylie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073718383 PECOS PAC ID: 6608275573 Enrollment ID: I20210525003424 |
| Provider Name | Maria S Sorin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144808809 PECOS PAC ID: 5991103442 Enrollment ID: I20211013002375 |
| Provider Name | Deborah Chinyere Onwuka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194313114 PECOS PAC ID: 8325446602 Enrollment ID: I20211018002487 |
| Provider Name | Karla Lundy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487298279 PECOS PAC ID: 7719376987 Enrollment ID: I20211109000765 |
| Provider Name | Allyson O Hummel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356991699 PECOS PAC ID: 1759770738 Enrollment ID: I20211112000950 |
| Provider Name | Marissa Fowler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780341057 PECOS PAC ID: 7719370956 Enrollment ID: I20220210000532 |
University Primary Care Practices Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9000 Mentor Ave Ste 204, Mentor, OH 44060 Phone: 216-383-0100 Fax: 216-383-6481 | |
Lake County Family Practice, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9500 Mentor Avenue, Suite 100, Mentor, OH 44060 Phone: 440-352-4880 Fax: 440-352-3629 | |
Hackett Medical Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8300 Tyler Blvd, Suite 300, Mentor, OH 44060 Phone: 440-205-1529 Fax: 440-205-0840 | |
Bowersox Wound Care Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6966 Heisley Rd Ste F, Mentor, OH 44060 Phone: 440-488-4575 | |
Wound Think Consulting, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5452 Grace Dr, Mentor, OH 44060 Phone: 440-227-2000 | |
Suhas Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9110 Mentor Ave Ste 9b, Mentor, OH 44060 Phone: 440-701-8030 |