NPIMap

Individual provider Active NPI

Charles W Haver, P.A.-C

  • Medical Physician Assistant
  • Streetsboro, OH
National Provider Identifier
1083626956
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
50-00-1714 Issued in OH
Practice address
9480 Rosemont Dr Ste 100
Streetsboro, OH 44241-4569
Phone
(330) 626-5566
Fax
(330) 626-2402
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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 50-00-1714 OH Primary

Addresses

Primary practice location

9480 Rosemont Dr Ste 100
Streetsboro, OH 44241-4569

Mailing address

PO Box 8792
Belfast, ME 04915-8792
Phone (330) 626-5566

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address charleshaverpa@portagefamilymedicine.medentdirect.com

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
I20100811000966 OH Practitioner - Physician Assistant 0143354282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716

158 W Main Rd
Conneaut, OH 44030-2039

9480 Rosemont Dr
Suite 100
Streetsboro, OH 44241-4569
Phone (216) 383-0100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.15 of 100Reported as apm
Quality
82.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc CurrentSince Aug 1, 2010 Accepting new patients
University Primary Care Practices Inc CurrentSince Aug 1, 2010 Accepting new patients
University Primary Care Practices Inc Past Accepting new patients
University Primary Care Practices Inc Past Accepting new patients

Locations

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

9480 Rosemont Dr
Ste 100
Streetsboro, OH 44241
Phone (330) 626-5566

Interoperability endpoints

  • Direct secure messaging: chaver28400@ehrdirect.uhhospitals.org

Organizations & group practices 5

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1083626956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8792",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049158792",
            "telephone_number": "330-626-5566",
            "fax_number": "330-626-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9480 ROSEMONT DR STE 100",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442414569",
            "telephone_number": "330-626-5566",
            "fax_number": "330-626-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVER",
        "first_name": "CHARLES",
        "middle_name": "W",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50-00-1714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charleshaverpa@portagefamilymedicine.medentdirect.com",
            "affiliation": "N",
            "address_1": "9480 Rosemont Dr Ste 100",
            "city": "Streetsboro",
            "state": "OH",
            "country_code": "US",
            "postal_code": "442414569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Streetsboro, OH

Sources for this page

Verify at the official NPI Registry.