Active NPI
Mandisa Molton
- Nurse Practitioner
- Cleveland, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- COA.19066-NP
- Practice address
- 2500 Metrohealth Dr
Cleveland, OH 44109-1900 - Phone
- (216) 778-7800
- NPI assigned
- May 10, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | COA.19066-NP | OH | |
| Gerontology Nurse Practitioner | 363LG0600X | COA.19066-NP | OH | |
| Primary Care Nurse Practitioner | 363LP2300X | COA.19066-NP | OH | |
| Nurse Practitioner | 363L00000X | COA.19066-NP | OH | Primary |
Addresses
Primary practice location
2500 Metrohealth Dr
Cleveland, OH 44109-1900
Mailing address
2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone (312) 733-9730
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mmolton216288@direct.metrohealth.org |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COA.19066-NP | OH | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Metrohealth System | Current | Accepting new patients | |
| The Metrohealth System | Current | Accepting new patients | |
| The Metrohealth System | Current | Accepting new patients |
Locations
11100 Saint Clair Ave
Cleveland, OH 44108
Phone (216) 664-7095
6705 Detroit Ave
Cleveland, OH 44102
Phone (216) 957-4905
2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348
19999 Rockside Rd
Cleveland, OH 44146
Phone (440) 439-6622
5208 Memphis Ave
Cleveland, OH 44144
Phone (216) 398-0100
15500 S Waterloo Rd
Cleveland, OH 44110
Phone (216) 696-3876
2816 E 116th St
Cleveland, OH 44120
Phone (216) 696-3876
3569 Ridge Rd
Cleveland, OH 44102
13263 Cedar Rd
Cleveland Heights, OH 44118
Phone (216) 320-2375
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 and National Provider Directory roles.
-
dba Metrohealth Professional Group
- Multi-Specialty Clinic/Center
- Cleveland, OH
- NPI 1053353896
-
dba Metrohealth Medical Center
- General Acute Care Hospital
- Cleveland, OH
- NPI 1700828852
-
dba MetroHealth Brooklyn Memphis Pharmacy
- Pharmacy
- Cleveland, OH
- NPI 1992529911
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699228800000",
"number": "1205282084",
"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",
"telephone_number": "312-733-9730",
"fax_number": "773-866-8014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 METROHEALTH DR",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441091900",
"telephone_number": "216-778-7800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOLTON",
"first_name": "MANDISA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-10",
"last_updated": "2023-11-06",
"certification_date": "2020-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "OH",
"license": "COA.19066-NP",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "OH",
"license": "COA.19066-NP",
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "OH",
"license": "COA.19066-NP",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OH",
"license": "COA.19066-NP",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mmolton216288@direct.metrohealth.org",
"affiliation": "N",
"address_1": "2500 Metrohealth Dr",
"city": "Cleveland",
"state": "OH",
"country_code": "US",
"postal_code": "441091900",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.