Individual provider Active NPI

Lisa M Mazzella

  • Adult Health Nurse Practitioner
  • Euclid, OH
National Provider Identifier
1053752576
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
14783-NP Issued in OH
Practice address
25301 Euclid Ave
Euclid, OH 44117-2609
Phone
(216) 261-6263
Fax
(216) 261-4964
NPI assigned
Jul 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.334407 OH
Adult Health Nurse Practitioner 363LA2200X 14783-NP OH Primary

Addresses

Primary practice location

25301 Euclid Ave
Euclid, OH 44117-2609

Mailing address

25301 Euclid Ave
Euclid, OH 44117-2609

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
I20131015001394 OH Practitioner - Nurse Practitioner 0547494148 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Partners in Nephrology Care LTDGroup PAC ID 8921997974, 21 clinicians
Cleveland Kidney and Hypertension Consultants IncGroup PAC ID 0840247763, 8 clinicians

Practice addresses (Care Compare)

18720 Chagrin Blvd
Shaker Heights, OH 44122-4855
Phone (216) 658-0458

25301 Euclid Ave
Second Floor
Euclid, OH 44117-2609
Phone (216) 261-6263

25301 Euclid Ave FL
Suite 2
Euclid, OH 44117-2609

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN.334407OHMDRegistered Nurse
14783-NPOHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Partners in Nephrology Care LTD. CurrentSince Jun 17, 2019 Accepting new patients
Cleveland Kidney & Hypertension Consultants Inc CurrentSince Aug 19, 2013 Accepting new patients

Locations

13170 Ravenna Rd
Ste 118
Chardon, OH 44024
Phone (440) 285-7874

25301 Euclid Ave
Fl 2
Euclid, OH 44117
Phone (216) 732-3750

25301 Euclid Ave
Fl Second
Euclid, OH 44117
Phone (216) 261-6263

25301 Euclid Ave
Euclid, OH 44117
Phone (216) 261-6263

6770 Mayfield Rd
Ste 447
Mayfield Heights, OH 44124
Phone (216) 545-4006

18720 Chagrin Blvd
Shaker Heights, OH 44122
Phone (216) 295-7003

Interoperability endpoints

  • Direct secure messaging: lmazzella28288@ehrdirect.uhhospitals.org

Organizations & group practices 2

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

Hospital & facility affiliations 2

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": "1373587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1053752576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25301 EUCLID AVE",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441172609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25301 EUCLID AVE",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441172609",
            "telephone_number": "216-261-6263",
            "fax_number": "216-261-4964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZELLA",
        "first_name": "LISA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-12",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.334407",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "14783-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Euclid, OH

Sources for this page

Verify at the official NPI Registry.