NPIMap

Individual provider Active NPI

Robert Mark Znidarsic, MD

  • Family Medicine Physician
  • Chardon, OH
National Provider Identifier
1144281288
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-071035 Issued in OH
Practice address
510 Fifth Ave
Chardon, OH 44024
Phone
(440) 279-1500
Fax
(440) 279-1501
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35-071035 OH Primary

Addresses

Primary practice location

510 Fifth Ave
Chardon, OH 44024

Mailing address

7590 Auburn Road, Suite 014
Attn: Med Staff
Willoughby, OH 44077-9176
Phone (440) 354-1899

Other identifiers 1

IdentifierTypeStateIssuer
2086620MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address robert.znidarsic@lhpg.eclinicaldirectplus.com Direct

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
I20040107000170 OH Practitioner - Family Practice 0749189983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Toledo College of Medicine, 1995
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)

11100 Euclid Ave
Cleveland, OH 44106-1716

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

510 5TH Ave
Chardon, OH 44024-1076
Phone (440) 286-8908

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35-071035OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Hospital System Inc CurrentSince Oct 1, 2003 Accepting new patients
Lake Hospital System Inc Family Medicine Current Accepting new patients
Lake Hospital System, Inc Family Medicine CurrentSince Oct 1, 2003 Accepting new patients
Lake Hospital System, Inc Family Medicine Past Accepting new patients
Lake Hospital System Inc Past Accepting new patients
Lake Hospital System Inc. Past Accepting new patients
Lake Hospital System Past Accepting new patients

Locations

510 5th Ave
Chardon, OH 44024
Phone (440) 285-9494

7590 Auburn Rd
Ste 14
Concord Township, OH 44077
Phone (440) 354-1899

25701 N Lakeland Blvd
Ste 305
Euclid, OH 44132
Phone (216) 731-5212

6270 N Ridge Rd
Madison, OH 44057
Phone (440) 428-8292

9500 Mentor Ave
Ste 100
Mentor, OH 44060
Phone (440) 352-4880

7956 Tyler Blvd
Mentor on Lk, OH 44060
Phone (440) 255-4455

10780 Kinsman Rd
Newbury, OH 44065
Phone (440) 564-5656

36100 Euclid Ave
Ste 240
Willoughby, OH 44094
Phone (216) 953-6294

30498 Lake Shore Blvd
Willowick, OH 44095
Phone (440) 585-3322

Interoperability endpoints

  • Direct secure messaging: rznidarsic37123@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 8

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1144281288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7590 AUBURN ROAD, SUITE 014",
            "address_2": "ATTN: MED STAFF",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440779176",
            "telephone_number": "440-354-1899",
            "fax_number": "440-354-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 FIFTH AVE",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "44024",
            "telephone_number": "440-279-1500",
            "fax_number": "440-279-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZNIDARSIC",
        "first_name": "ROBERT",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-071035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2086620",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "robert.znidarsic@lhpg.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Baseline West Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "510 Fifth Ave",
            "city": "Chardon",
            "state": "OH",
            "country_code": "US",
            "postal_code": "44024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chardon, OH

Sources for this page

Verify at the official NPI Registry.