NPIMap

Individual provider Active NPI

Victoria Celeste Radel, PA-C

  • Medical Physician Assistant
  • Mentor, OH
National Provider Identifier
1063130722
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
8655 Market St Ste 200
Mentor, OH 44060-4112
Phone
(440) 255-7938
NPI assigned
Aug 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

8655 Market St Ste 200
Mentor, OH 44060-4112

Mailing address

9180 Pleasantvale CT
Mentor, OH 44060-7334
Phone (440) 897-9221

Other identifiers 1

IdentifierTypeStateIssuer
50.007775RXOtherOHELICENSE OHIO PROFESSIONAL LICENSE

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
I20220926001115 OH Practitioner - Physician Assistant 9638555840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lake Hospital System, Inc.Group PAC ID 6002713922, 92 clinicians

Practice addresses (Care Compare)

36500 Euclid Ave
Willoughby, OH 44094-4455
Phone (440) 516-0530

8655 Market St
Mentor, OH 44060-4112
Phone (440) 255-6400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Hospital System Inc CurrentSince Oct 10, 2022 Accepting new patients
Lake Hospital System, Inc CurrentSince Oct 10, 2022 Accepting new patients
Lake Hospital System, Inc PastSince Aug 28, 2022 Accepting new patients

Locations

8655 Market St
Ste 200
Mentor, OH 44060
Phone (440) 255-7938

8655 Market St
Mentor, OH 44060
Phone (440) 255-6400

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

Interoperability endpoints

  • Direct secure messaging: vradel219643@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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1063130722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9180 PLEASANTVALE CT",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440607334",
            "telephone_number": "440-897-9221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8655 MARKET ST STE 200",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604112",
            "telephone_number": "440-255-7938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADEL",
        "first_name": "VICTORIA",
        "middle_name": "CELESTE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELICENSE OHIO PROFESSIONAL LICENSE",
            "identifier": "50.007775RX",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

Verify at the official NPI Registry.