NPIMap

Individual provider Active NPI

John Michael Allen, D.O.

  • Family Medicine Physician
  • Mentor, OH
National Provider Identifier
1215514815
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34.017207 Issued in OH
Practice address
9500 Mentor Avenue
Suite 100
Mentor, OH 44060-8702
Phone
(440) 898-1021
NPI assigned
Mar 28, 2021
Last updated
Jul 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34.017207 OH Primary

Addresses

Primary practice location

9500 Mentor Avenue
Suite 100
Mentor, OH 44060-8702

Mailing address

9500 Mentor Ave Ste 100
Mentor, OH 44060-8702
Phone (440) 898-1021

Other practice location 1

27100 Chardon Rd
Richmond Heights, OH 44143-1116
Phone (440) 585-6500

Other identifiers 1

IdentifierTypeStateIssuer
0445696MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240911002172 OH Practitioner - Internal Medicine 6507306016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ohio University, College of Osteopathic Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Hospital System, Inc.Group PAC ID 6002713922, 92 clinicians

Practice addresses (Care Compare)

9500 Mentor Ave
Suite 100
Mentor, OH 44060-8702
Phone 44035274880

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34.017207OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Hospital System, Inc Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
The Metrohealth System Current Accepting new patients
Lake Hospital System Inc Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
Lake Hospital System, Inc Family Medicine Past Accepting new patients
University Hospitals Medical Group Inc Past Accepting new patients

Locations

9500 Mentor Ave
Ste 100
Mentor, OH 44060
Phone (440) 352-4880

10780 Kinsman Rd
Newbury, OH 44065
Phone (440) 564-5656

Interoperability endpoints

  • Direct secure messaging: jallen214367@direct.metrohealth.org
  • Direct secure messaging: jallen38681@ehrdirect.uhhospitals.org

Organizations & group practices 5

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 7

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": "1616889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1215514815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 MENTOR AVE STE 100",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440608702",
            "telephone_number": "440-898-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 MENTOR AVENUE",
            "address_2": "SUITE 100",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440608702",
            "telephone_number": "440-898-1021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27100 Chardon Rd",
            "address_purpose": "LOCATION",
            "city": "Richmond Heights",
            "state": "OH",
            "postal_code": "441431116",
            "country_code": "US",
            "telephone_number": "440-585-6500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-28",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.017207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445696",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

Verify at the official NPI Registry.