Individual provider Active NPI

Jaclyn Venczel, PA-C

  • Physician Assistant
  • Cleveland, OH
National Provider Identifier
1073992616
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.004260 Issued in OH
Practice address
9500 Euclid Ave
Cleveland, OH 44195-5114
Phone
(440) 312-3130
NPI assigned
May 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 50.004260 OH Primary

Addresses

Primary practice location

9500 Euclid Ave
Cleveland, OH 44195-5114

Mailing address

2118 Murray Hill Rd Apt 2
Cleveland, OH 44106-5926

Other practice location 1

11000 W Pleasant Valley Rd
Parma, OH 44130-5114
Phone (216) 987-6000

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
I20150817001617 OH Practitioner - Physician Assistant 4284949421 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

6780 Mayfield Rd
Mayfield Heights, OH 44124-2203
Phone (440) 449-4500

8300 Norton Pkwy
Mentor, OH 44060-6601
Phone (216) 444-2200

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cleveland Clinic Health System - East Region CurrentSince Jun 16, 2024 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Jul 8, 2015 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Jul 8, 2015 Accepting new patients

Locations

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

6780 Mayfield Rd
Mayfield Hts, OH 44124
Phone (440) 331-9520

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Organizations & group practices 3

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 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": "1432771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1073992616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2118 MURRAY HILL RD APT 2",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441065926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441955114",
            "telephone_number": "440-312-3130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11000 W Pleasant Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Parma",
            "state": "OH",
            "postal_code": "441305114",
            "country_code": "US",
            "telephone_number": "216-987-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VENCZEL",
        "first_name": "JACLYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-28",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.004260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.