Individual provider Active NPI

Haley Kozminski

  • Psychiatric/Mental Health Nurse Practitioner
  • Medina, OH
National Provider Identifier
1215650288
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0032324 Issued in OH
Practice address
3593 Medina Rd # 181
Medina, OH 44256-8182
Phone
(330) 536-3746
NPI assigned
Sep 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11038543 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704424811 MI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4043198 KY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0032324 OH Primary

Addresses

Primary practice location

3593 Medina Rd # 181
Medina, OH 44256-8182

Mailing address

3567 Reserve Commons Dr Ste 100
Medina, OH 44256-5344
Phone (330) 536-3746

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
I20221026001653 OH Practitioner - Nurse Practitioner 7810363264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
98.06 of 100Reported as group
Quality
90.22
Promoting interoperability
100
Improvement activities
40
Cost
69.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11038543FLMDPsychiatric/Mental Health Nurse Practitioner
4043198KYMDPsychiatric/Mental Health Nurse Practitioner
4704424811MIMDPsychiatric/Mental Health Nurse Practitioner
0032324OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alcove Ventures LLC Psychiatric/Mental Health CurrentSince Sep 23, 2022 Accepting new patients
The Metrohealth System CurrentSince Jun 26, 2024 Accepting new patients
The Metrohealth System CurrentSince Jun 26, 2024 Accepting new patients

Locations

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

3567 Reserve Commons Dr
Ste 100
Medina, OH 44256
Phone (330) 664-9250

3593 Medina Rd
Medina, OH 44256
Phone (330) 664-9250

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1215650288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3567 RESERVE COMMONS DR STE 100",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565344",
            "telephone_number": "330-536-3746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3593 MEDINA RD # 181",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442568182",
            "telephone_number": "330-536-3746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZMINSKI",
        "first_name": "HALEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-23",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11038543",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704424811",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "4043198",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "0032324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

Verify at the official NPI Registry.