Individual provider Active NPI

Justin Mastrucci, FNP-BC

  • Family Nurse Practitioner
  • Fairlawn, OH
National Provider Identifier
1124727888
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0032261 Issued in OH
Practice address
3600 W Market St Ste 200
Fairlawn, OH 44333-4540
Phone
(330) 666-2700
NPI assigned
Mar 1, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0032261 OH Primary

Addresses

Primary practice location

3600 W Market St Ste 200
Fairlawn, OH 44333-4540

Mailing address

23951 Delmere Dr
North Olmsted, OH 44070-1573
Phone (810) 394-5906

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
I20230511000843 OH Practitioner - Nurse Practitioner 5597121897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Partners Physician GroupGroup PAC ID 4183529340, 409 clinicians

Practice addresses (Care Compare)

3600 W Market St
Suite 200
Fairlawn, OH 44333-4540
Phone (330) 666-2700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0032261OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Partners Physician Group CurrentSince Apr 7, 2023 Accepting new patients
Partners Physician Group CurrentSince Apr 7, 2023 Accepting new patients
Partners Physician Group Past Accepting new patients

Locations

224 W Exchange St
Ste 225
Akron, OH 44302
Phone (330) 344-7400

224 W Exchange St
Ste 160
Akron, OH 44302
Phone (330) 344-6505

1 Akron General Ave
Akron, OH 44307
Phone (330) 344-5760

3600 W Market St
Ste 200
Fairlawn, OH 44333
Phone (330) 666-2700

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 4

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": "1677628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1124727888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23951 DELMERE DR",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440701573",
            "telephone_number": "810-394-5906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 W MARKET ST STE 200",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443334540",
            "telephone_number": "330-666-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTRUCCI",
        "first_name": "JUSTIN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-01",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0032261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairlawn, OH

Sources for this page

Verify at the official NPI Registry.