Individual provider Active NPI

James Robert Schroeder, CNP, RN

  • Adult Health Nurse Practitioner
  • Mentor, OH
National Provider Identifier
1104380328
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN280539 Issued in OH
Practice address
7232 Justin Way
Mentor, OH 44060-4881
Phone
(440) 578-8200
NPI assigned
Jan 23, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.280539 OH
Adult Health Nurse Practitioner 363LA2200X RN280539 OH Primary

Addresses

Primary practice location

7232 Justin Way
Mentor, OH 44060-4881

Mailing address

7232 Justin Way
Mentor, OH 44060-4881
Phone (440) 578-8200

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
I20200130001019 OH Practitioner - Nurse Practitioner 5294161824 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nagy Healthcare LLCGroup PAC ID 0941563605, 10 clinicians

Practice addresses (Care Compare)

196 Colonial Dr
Youngstown, OH 44505-2139
Phone (833) 720-6249

60 W St
Geneva, OH 44041-9723
Phone (833) 720-6249

Hospital & facility affiliations

  • Uhhs Memorial Hospital of Geneva Hospital, Geneva, OH, CCN 361307

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN.280539OHMDRegistered Nurse
RN280539OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Hospital System, Inc CurrentSince Dec 7, 2020 Accepting new patients
Lake Hospital System, Inc. CurrentSince Dec 7, 2020 Accepting new patients
Lake Hospital System Inc Nurse Practitioner Current Accepting new patients
Nagy Healthcare LLC CurrentSince Aug 18, 2021 Accepting new patients
Suhas LLC PastSince Mar 10, 2021 Accepting new patients

Locations

60 West St
Geneva, OH 44041
Phone (440) 466-1181

8300 Tyler Blvd
Ste 102
Mentor, OH 44060
Phone (440) 205-0242

196 Colonial Dr
Youngstown, OH 44505
Phone (234) 232-7500

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 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": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1104380328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7232 JUSTIN WAY",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604881",
            "telephone_number": "440-578-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7232 JUSTIN WAY",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604881",
            "telephone_number": "440-578-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "JAMES",
        "middle_name": "ROBERT",
        "credential": "CNP, RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-23",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.280539",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "RN280539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

Verify at the official NPI Registry.