Individual provider Active NPI

Ashley Suffoletto

  • Medical Physician Assistant
  • Powell, OH
National Provider Identifier
1205259405
Registry record updated Apr 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
10330 Sawmill Pkwy
Suite 300
Powell, OH 43065-7790
Phone
(614) 794-0481
Fax
(614) 794-3711
NPI assigned
Jan 24, 2014
Last updated
Apr 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NU Primary

Addresses

Primary practice location

10330 Sawmill Pkwy
Suite 300
Powell, OH 43065-7790

Mailing address

575 Copeland Mill Rd
Suite 1D
Westerville, OH 43081-8977
Phone (614) 794-0481

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
I20140422000828 OH Practitioner - Physician Assistant 3173755394 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wedgewood Urgent Care, LTDGroup PAC ID 1557266129, 26 clinicians

Practice addresses (Care Compare)

1958 E US Hwy 36
Urbana, OH 43078-9799
Phone (937) 652-5019

444 N Cleveland Ave
Westerville, OH 43082-8388
Phone (614) 839-1118

4460 Lake Forest Dr
Suite 216
Blue Ash, OH 45242-3755
Phone (513) 281-4400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Immediate Health Associates Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1390521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554422400000",
    "number": "1205259405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 COPELAND MILL RD",
            "address_2": "SUITE 1D",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430818977",
            "telephone_number": "614-794-0481",
            "fax_number": "614-794-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10330 SAWMILL PKWY",
            "address_2": "SUITE 300",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430657790",
            "telephone_number": "614-794-0481",
            "fax_number": "614-794-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUFFOLETTO",
        "first_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-24",
        "last_updated": "2019-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Powell, OH

Sources for this page

Verify at the official NPI Registry.