Jacqulyn Stachowiak

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.019712 Issued in OH

Practice address

27076 Bagley Road
Olmsted TWP, OH 44138

Phone

(440) 816-8380

Fax

(440) 816-8383

NPI assigned

Aug 22, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwest General Medical Group IncGroup PAC ID 8527964550, 232 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southwest General Health Center Hospital, Middleburg Heights, OH, CCN 360155

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacqulyn.stachowiak@79171750068228.direct.elationemr.com

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.

• Southwest General Medical Group Inc

  • Internal Medicine Physician
  • Cleveland, OH
  • NPI 1134239676
  Medicare reassignment Care Compare group NPD
• Southwest General Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Middleburg HTS, OH
  • NPI 1588393979
  NPD
• Southwest General Medical Group, Inc

  • Pain Medicine (Anesthesiology) Physician
  • Cleveland, OH
  • NPI 1205985967
  NPD

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

• Southwest General Health Center

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1154353993
  Care Compare affiliation

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

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1073068896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27076 BAGLEY ROAD",
            "city": "OLMSTED TWP",
            "state": "OH",
            "postal_code": "44138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27076 BAGLEY ROAD",
            "city": "OLMSTED TWP",
            "state": "OH",
            "postal_code": "44138",
            "telephone_number": "440-816-8380",
            "fax_number": "440-816-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACHOWIAK",
        "first_name": "JACQULYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-22",
        "last_updated": "2022-06-03",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.019712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jstachowiak@direct.swgeneral.com",
            "affiliation": "Y",
            "affiliationName": "Southwest General Medical Group, Inc.",
            "address_1": "18780 Bagley Rd Ste 104",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441303304",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jstachowiak@direct.swgeneral.com",
            "affiliation": "Y",
            "affiliationName": "Southwest General Medical Group Inc",
            "address_1": "27076 Bagley Road",
            "city": "Olmsted Twp",
            "state": "OH",
            "country_code": "US",
            "postal_code": "44138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicholas Shamhart
• Shiny M Abraham LLC
• Lynn Marie Skunta
• Kelsey Rose Snider
• Megan E Sprenger, LPC
• Lori Stella
• Matthew A Stevens, DO
• Timothy P. Stipek, BA, MSSA, LISW-SUPV
• The Cleveland Clinic Foundation
• Courtney Truscott

• Family Nurse Practitioner in Olmsted TWP, OH
• Providers in Olmsted TWP, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.