Individual provider Active NPI

Kristin Jeanne Ortopan, PA-C, MSHS

  • Physician Assistant
  • Parma, OH
National Provider Identifier
1144530536
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.003175 Issued in OH
Practice address
12301 Snow Rd
Parma, OH 44130-1002
Phone
(216) 362-2123
Fax
(216) 362-2779
NPI assigned
Oct 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

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 50.003175 OH Primary

Addresses

Primary practice location

12301 Snow Rd
Parma, OH 44130-1002

Mailing address

2500 Metrohealth Dr
Cleveland, OH 44109-1900

Other names 1

  • Kristin Jeanne Readence 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
I20121015000742 OH Practitioner - Physician Assistant 0446400188 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview HospitalGroup PAC ID 4688571730, 74 clinicians

Practice addresses (Care Compare)

10654 Lorain Ave
Cleveland, OH 44111-5411
Phone (216) 941-1044

18101 Lorain Ave
Cleveland, OH 44111-5612
Phone (216) 476-7000

Hospital & facility affiliations

  • Fairview Hospital Hospital, Cleveland, OH, CCN 360077

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.003175OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Hospital Physician Assistant CurrentSince Jun 15, 2020 Accepting new patients
The Metrohealth System CurrentSince Mar 15, 2016 Accepting new patients

Locations

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

10654 Lorain Ave
Cleveland, OH 44111
Phone (216) 941-1044

12301 Snow Rd
Parma Heights, OH 44130
Phone (216) 285-8810

Organizations & group practices 2

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": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455494400000",
    "number": "1144530536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 SNOW RD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441301002",
            "telephone_number": "216-362-2123",
            "fax_number": "216-362-2779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTOPAN",
        "first_name": "KRISTIN",
        "middle_name": "JEANNE",
        "credential": "PA-C, MSHS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-19",
        "last_updated": "2016-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "READENCE",
            "middle_name": "JEANNE",
            "credential": "PA-C, MSHS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Parma, OH

Sources for this page

Verify at the official NPI Registry.