Individual provider Active NPI

Mandy M Fishburn, PA-C

  • Physician Assistant
  • Cuyahoga Falls, OH
National Provider Identifier
1215440714
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.005252RX Issued in OH
Practice address
1900 23Rd St
Cuyahoga Falls, OH 44223-1404
Phone
(330) 971-7246
Fax
(330) 971-7256
NPI assigned
Nov 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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 50.005252RX OH Primary

Addresses

Primary practice location

1900 23Rd St
Cuyahoga Falls, OH 44223-1404

Mailing address

4330 Timberbrook Dr
Canfield, OH 44406-9366
Phone (330) 718-6013

Other names 1

  • Mandy M Schneider Former name

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
I20171201000385 OH Practitioner - Physician Assistant 0547527442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthounited, Inc.Group PAC ID 9032197868, 89 clinicians

Practice addresses (Care Compare)

4760 Belpar St NW
Canton, OH 44718-3603
Phone (330) 492-9200

7442 Frank Ave NW
North Canton, OH 44720-7018
Phone (330) 305-0838

Hospital & facility affiliations

  • Aultman Hospital Hospital, Canton, OH, CCN 360084
  • Mercy Medical Center Hospital, Canton, OH, CCN 360070

Merit-based Incentive Payment System (MIPS)

Final score
80.13 of 100Reported as group
Quality
74.6
Promoting interoperability
70
Improvement activities
40
Cost
84.16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.005252RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthounited, Inc. CurrentSince Nov 13, 2023 Accepting new patients

Locations

2211 W State St
Alliance, OH 44601
Phone (330) 680-8735

4760 Belpar St NW
Canton, OH 44718
Phone (330) 244-1001

340 Oxford St
Ste 102
Dover, OH 44622
Phone (330) 602-3200

7442 Frank Ave NW
North Canton, OH 44720
Phone (330) 305-0838

Interoperability endpoints

  • Direct secure messaging: mfishburn@omni.medentdirect.com

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 2

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": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1215440714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 TIMBERBROOK DR",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069366",
            "telephone_number": "330-718-6013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 23RD ST",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442231404",
            "telephone_number": "330-971-7246",
            "fax_number": "330-971-7256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHBURN",
        "first_name": "MANDY",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-07",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005252RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDY",
            "last_name": "SCHNEIDER",
            "middle_name": "M",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cuyahoga Falls, OH

Sources for this page

Verify at the official NPI Registry.