Individual provider Active NPI

Danielle Spatholt, PA-C

  • Physician Assistant
  • Strongsville, OH
National Provider Identifier
1033459151
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
003717 Issued in OH
Practice address
16712 Pearl Rd
Strongsville, OH 44136-6049
Phone
(440) 238-0360
Fax
(440) 238-8835
NPI assigned
Feb 26, 2013
Last updated
Nov 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 003717 OH Primary

Addresses

Primary practice location

16712 Pearl Rd
Strongsville, OH 44136-6049

Mailing address

16712 Pearl Rd
Strongsville, OH 44136-6049
Phone (440) 238-0360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130610000638 OH Practitioner - Physician Assistant 3971742610 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatologists of Southwestern Ohio, LLCGroup PAC ID 7113973041, 116 clinicians

Practice addresses (Care Compare)

36701 American Way
Suite 3
Avon, OH 44011-4064
Phone (440) 937-4951

5300 Far Hills Ave
Dayton, OH 45429-2381
Phone (937) 433-7536

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
003717OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Hospital CurrentSince Mar 1, 2013 Accepting new patients
Dermatology Partners, Inc. PastSince Mar 1, 2006 Accepting new patients

Locations

10654 Lorain Ave
Cleveland, OH 44111
Phone (216) 941-1044

18101 Lorain Ave
Cleveland, OH 44111
Phone (216) 476-7029

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

Interoperability endpoints

  • Direct secure messaging: dspatholt@dermswohio.emadirect.md

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 1

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": "1361836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1033459151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16712 PEARL RD",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441366049",
            "telephone_number": "440-238-0360",
            "fax_number": "440-238-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16712 PEARL RD",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441366049",
            "telephone_number": "440-238-0360",
            "fax_number": "440-238-8835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPATHOLT",
        "first_name": "DANIELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-26",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "003717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Strongsville, OH

Sources for this page

Verify at the official NPI Registry.