Organization Active NPI

Dr Jerome J Lamendola LLC

  • Foot & Ankle Surgery Podiatrist
  • Lakewood, OH
National Provider Identifier
1154640217
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
36002157 Issued in OH
Legal business name
DR JEROME J LAMENDOLA LLC
Practice address
15810 Detroit Ave
Lakewood, OH 44107-3711
Phone
(216) 529-1800
Fax
(216) 529-3201
NPI assigned
May 27, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

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

Authorized official

Name
Ms. Judy Klecan
Title
Office Manager
Phone
(216) 529-1800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 36002157 OH Primary

Addresses

Primary practice location

15810 Detroit Ave
Lakewood, OH 44107-3711

Mailing address

15810 Detroit Ave
Lakewood, OH 44107-3711
Phone (216) 529-1800

Other identifiers 1

IdentifierTypeStateIssuer
3068077MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100720000486 OH Part B Supplier - Clinic/Group Practice 8527190958 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
Practice locations: Lakewood, OH
O20100930017711 OH DME Supplier - Physician - Podiatry 8527190958 Practice locations: Lakewood, OH

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

15810 Detroit Ave
Lakewood, OH 44107
Phone (216) 226-7512

4325 Green Rd
Warrensville Heights, OH 44128
Phone (216) 464-7400

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1274918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287100800000",
    "number": "1154640217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15810 DETROIT AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441073711",
            "telephone_number": "216-529-1800",
            "fax_number": "216-529-3201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15810 DETROIT AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441073711",
            "telephone_number": "216-529-1800",
            "fax_number": "216-529-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JEROME J LAMENDOLA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-27",
        "last_updated": "2010-10-15",
        "status": "A",
        "authorized_official_last_name": "KLECAN",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "216-529-1800",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36002157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3068077",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.