Individual provider Active NPI

Gwyneth Ellen Markowitz, PA

  • Physician Assistant
  • Mentor, OH
National Provider Identifier
1124904479
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
9485 Mentor Ave
Mentor, OH 44060-4597
Phone
(440) 701-6612
NPI assigned
Aug 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

9485 Mentor Ave
Mentor, OH 44060-4597

Mailing address

135 Mill Run
Aurora, OH 44202-6707
Phone (440) 665-7129

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
I20251007002560 OH Practitioner - Physician Assistant 7517464522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lake Hospital System, Inc.Group PAC ID 6002713922, 92 clinicians

Practice addresses (Care Compare)

36500 Euclid Ave
Willoughby, OH 44094-4455
Phone (440) 516-0530

9485 Mentor Ave
Mentor, OH 44060-8723

Hospital & facility affiliations

  • Lake Health Hospital, Concord, OH, CCN 360098
  • Uh Cleveland Medical Center Hospital, Cleveland, OH, CCN 360137
  • Uh Regional Hospitals Hospital, Chardon, OH, CCN 360075

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Hospital System Inc Physician Assistant Current Accepting new patients
Lake Hospital System, Inc CurrentSince Sep 25, 2025 Accepting new patients
Lake Hospital System, Inc. CurrentSince Sep 25, 2025 Accepting new patients
Lake Hospital System, Inc Past Accepting new patients

Locations

9485 Mentor Ave
Ste 210
Mentor, OH 44060
Phone (440) 205-5835

9485 Mentor Ave
Mentor on Lk, OH 44060
Phone (440) 205-5755

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 6

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": "1755043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1124904479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 MILL RUN",
            "city": "AURORA",
            "state": "OH",
            "postal_code": "442026707",
            "telephone_number": "440-665-7129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9485 MENTOR AVE",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604597",
            "telephone_number": "440-701-6612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKOWITZ",
        "first_name": "GWYNETH",
        "middle_name": "ELLEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-13",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

Verify at the official NPI Registry.