Individual provider Active NPI

Amanda Cafarelli De Leon

  • Nurse Practitioner
  • Berea, OH
National Provider Identifier
1134516115
Registry record updated Nov 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AG0315112 Issued in OH
Practice address
563 W Bagley Rd
Berea, OH 44017-1328
Phone
(440) 234-8455
NPI assigned
Apr 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AG0315112 OH Primary

Addresses

Primary practice location

563 W Bagley Rd
Berea, OH 44017-1328

Mailing address

563 W Bagley Rd
Berea, OH 44017-1328
Phone (440) 234-0502

Other names 1

  • Amanda Marie Cafarelli Former name

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
I20150522001435 OH Practitioner - Nurse Practitioner 7911227467 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Primary Care Practices IncGroup PAC ID 3072417534, 1,071 clinicians

Practice addresses (Care Compare)

630 E River St
Elyria, OH 44035-5902
Phone (440) 329-7500

Hospital & facility affiliations

  • University Hospitals - Elyria Medical Center Hospital, Elyria, OH, CCN 360145
  • Uh St John Medical Center Hospital, Westlake, OH, CCN 360123

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
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AG0315112OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc CurrentSince Sep 11, 2024 Accepting new patients
University Primary Care Practices Inc Current Accepting new patients
Emh Regional Medical Center CurrentSince Jan 25, 2020 Accepting new patients
University Primary Care Practices Inc CurrentSince Sep 11, 2024 Accepting new patients
Emh Regional Medical Center Nurse Practitioner CurrentSince Jan 25, 2020 Accepting new patients
Emh Regional Medical Center Current Accepting new patients
Multicare Health System Nurse Practitioner Past Accepting new patients

Locations

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

630 E River St
Elyria, OH 44035
Phone (440) 329-7450

Interoperability endpoints

  • Direct secure messaging: adeleon28099@ehrdirect.uhhospitals.org

Organizations & group practices 7

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 2

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": "1429228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1134516115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "563 W BAGLEY RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440171328",
            "telephone_number": "440-234-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "563 W BAGLEY RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440171328",
            "telephone_number": "440-234-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LEON",
        "first_name": "AMANDA",
        "middle_name": "CAFARELLI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-17",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "AG0315112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "CAFARELLI",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Berea, OH

Sources for this page

Verify at the official NPI Registry.