Active NPI
City of Mentor Lake County
- Ambulance
- Mentor, OH
National Provider Identifier
1063570141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulance
- Legal business name
- CITY OF MENTOR LAKE COUNTY
- Practice address
- 8467 Civic Center Blvd
Mentor, OH 44060-2415 - Phone
- (440) 974-5765
- NPI assigned
- Dec 4, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ron Zak
- Title
- Chief
- Phone
- (440) 974-5765
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | Primary |
Addresses
Primary practice location
8467 Civic Center Blvd
Mentor, OH 44060-2415
Mailing address
PO Box 392907
Pittsburgh, PA 15251-9907
Phone (800) 962-1484
Other names 1
- Mentor Fire Department
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070202000267 | OH | Part B Supplier - Ambulance Service Supplier | 9133121262 | Practice locations: Mentor, OH |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D0861744 | Mentor Fire Department | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryLocations
5025 Corduroy Rd
Mentor, OH 44060
Phone (440) 257-6457
6900 Reynolds Rd
Mentor, OH 44060
Phone (440) 974-5704
8467 Civic Center Blvd
Mentor, OH 44060
Phone (440) 974-5765
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1779840000000",
"number": "1063570141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 392907",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152519907",
"telephone_number": "800-962-1484",
"fax_number": "513-772-4464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8467 CIVIC CENTER BLVD",
"city": "MENTOR",
"state": "OH",
"postal_code": "440602415",
"telephone_number": "440-974-5765"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CITY OF MENTOR LAKE COUNTY",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-04",
"last_updated": "2026-05-27",
"certification_date": "2026-05-27",
"status": "A",
"authorized_official_last_name": "ZAK",
"authorized_official_first_name": "RON",
"authorized_official_title_or_position": "CHIEF",
"authorized_official_telephone_number": "440-974-5765"
},
"taxonomies": [
{
"code": "341600000X",
"taxonomy_group": "",
"desc": "Ambulance",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Mentor Fire Department",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Mentor, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.