Individual provider Active NPI

Nicole Katharine Harder, PA-C

  • Physician Assistant
  • Lorain, OH
National Provider Identifier
1215208988
Registry record updated Jan 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.003435 Issued in OH
Practice address
5700 Cooper Foster Park Rd W
Lorain, OH 44053-4140
Phone
(440) 204-7220
NPI assigned
Jan 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2017

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 50.003435 OH Primary

Addresses

Primary practice location

5700 Cooper Foster Park Rd W
Lorain, OH 44053-4140

Mailing address

311 Crestmont Cir
Avon Lake, OH 44012-3150
Phone (440) 258-2530

Other identifiers 1

IdentifierTypeStateIssuer
50.003435OtherOHOHIO STATE MEDICAL BOARD, PHYSICIAN ASSISTANT LICENSE

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
I20120306000597 OH Practitioner - Physician Assistant 5395904692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

33100 Cleveland Clinic Blvd
Avon, OH 44011-1390
Phone (440) 695-4000

5334 Meador Lane CT
Sheffield Village, OH 44035-1469

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.003435OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Jan 31, 2012 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Jan 31, 2012 Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

5700 Cooper Foster Park Rd W
Lorain, OH 44053
Phone (440) 204-7400

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": "1327536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483920000000",
    "number": "1215208988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 CRESTMONT CIR",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440123150",
            "telephone_number": "440-258-2530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 COOPER FOSTER PARK RD W",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440534140",
            "telephone_number": "440-204-7220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDER",
        "first_name": "NICOLE",
        "middle_name": "KATHARINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-26",
        "last_updated": "2017-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO STATE MEDICAL BOARD, PHYSICIAN ASSISTANT LICENSE",
            "identifier": "50.003435",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorain, OH

Sources for this page

Verify at the official NPI Registry.