Individual provider Active NPI

Patrick Edward Boyle

  • Social Worker
  • Cleveland Heights, OH
National Provider Identifier
1174853055
Registry record updated Dec 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
0004916 Issued in OH
Practice address
2490 Lee Blvd
Suite 314
Cleveland Heights, OH 44118-1268
Phone
(216) 287-6691
Fax
(216) 398-6350
NPI assigned
Dec 28, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 0004916 OH Primary

Addresses

Primary practice location

2490 Lee Blvd
Suite 314
Cleveland Heights, OH 44118-1268

Mailing address

2490 Lee Blvd
Suite 314
Cleveland Heights, OH 44118-1268
Phone (216) 287-6691

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131007001572 OH Practitioner - Clinical Social Worker 2567696503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Humanistic Counseling Center LLCGroup PAC ID 9335044619, 28 clinicians

Practice addresses (Care Compare)

12417 Cedar Rd
Suite 23
Cleveland, OH 44106-3157
Phone (216) 839-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0004916OHMDSocial Worker

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1261958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261958400000",
    "number": "1174853055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2490 LEE BLVD",
            "address_2": "SUITE 314",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441181268",
            "telephone_number": "216-287-6691",
            "fax_number": "216-398-6350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 LEE BLVD",
            "address_2": "SUITE 314",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441181268",
            "telephone_number": "216-287-6691",
            "fax_number": "216-398-6350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLE",
        "first_name": "PATRICK",
        "middle_name": "EDWARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-28",
        "last_updated": "2009-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "0004916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland Heights, OH

Sources for this page

Verify at the official NPI Registry.