NPIMap

Individual provider Active NPI

Sara Jane Brown

  • Family Medicine Physician
  • Mentor, OH
National Provider Identifier
1003312760
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.142248 Issued in OH
Practice address
9500 Mentor Ave Ste 100
Mentor, OH 44060-8702
Phone
(440) 352-4880
Fax
(440) 352-3629
NPI assigned
Apr 2, 2018
Last updated
Nov 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 35.142248 OH Primary

Addresses

Primary practice location

9500 Mentor Ave Ste 100
Mentor, OH 44060-8702

Mailing address

30615 Willowick Dr
Willowick, OH 44095-3748
Phone (440) 796-7763

Other practice location 1

2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone (216) 778-4486

Other identifiers 1

IdentifierTypeStateIssuer
0293379MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211202002157 OH Practitioner - Family Practice 3072869403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Northeastern Ohio University College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Hospital System, Inc.Group PAC ID 6002713922, 92 clinicians

Practice addresses (Care Compare)

9500 Mentor Ave
Suite 100
Mentor, OH 44060-8702
Phone 44035274880

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Hospital System, Inc Family Medicine CurrentSince Jan 3, 2022 Accepting new patients
Lake Hospital System Family Medicine CurrentSince Jan 3, 2022 Accepting new patients
Lake Hospital System Inc Family Medicine Current Accepting new patients
Lake Hospital System, Inc Family Medicine Past Accepting new patients

Locations

9500 Mentor Ave
Ste 100
Mentor, OH 44060
Phone (440) 352-4880

10780 Kinsman Rd
Newbury, OH 44065
Phone (440) 564-5656

Networks

  • KY PPO
  • devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9
  • devoted network organization-2d523d8e-e8f9-454a-bcd3-333df65bdbe8
  • KY PPO C-SNP
  • devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
  • devoted network organization-9f3dfbd3-4aa6-4c92-8e71-9c4ed35ce037
  • OH PPO

Interoperability endpoints

  • Direct secure messaging: sbrown37250@ehrdirect.uhhospitals.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1003312760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30615 WILLOWICK DR",
            "city": "WILLOWICK",
            "state": "OH",
            "postal_code": "440953748",
            "telephone_number": "440-796-7763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 MENTOR AVE STE 100",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440608702",
            "telephone_number": "440-352-4880",
            "fax_number": "440-352-3629"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Metrohealth Dr",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441091900",
            "country_code": "US",
            "telephone_number": "216-778-4486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SARA",
        "middle_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-02",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.142248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0293379",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

Verify at the official NPI Registry.