NPIMap

Individual provider Active NPI

Laura M. Distel, M.D.

  • Family Medicine Physician
  • Wadsworth, OH
National Provider Identifier
1225156672
Registry record updated Jan 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35093592 Issued in OH
Practice address
185 Wadsworth Rd
Suite D
Wadsworth, OH 44281-8330
Phone
(330) 331-7106
Fax
(330) 331-7556
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 35093592 OH
Family Medicine Physician 207Q00000X 35093592 OH Primary

Addresses

Primary practice location

185 Wadsworth Rd
Suite D
Wadsworth, OH 44281-8330

Mailing address

185 Wadsworth Rd
Suite D
Wadsworth, OH 44281-8330
Phone (330) 331-7106

Other identifiers 1

IdentifierTypeStateIssuer
3090926MedicaidOH

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
I20101117001660 OH Practitioner - Family Practice 5092901918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Medicine, 2006
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)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-2200

Hospital & facility affiliations

  • Cleveland Clinic Home Care Home health agency, Independence, OH, CCN 367142
  • Patriot Homecare, Inc Home health agency, Girard, OH, CCN 368406
  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
  • Medina Hospital Hospital, Medina, OH, CCN 360091
  • Akron General Medical Center Hospital, Akron, OH, CCN 360027
  • Lodi Community Hospital Hospital, Lodi, OH, CCN 361303
  • Summa Health System Hospital, Akron, OH, CCN 360020
  • Western Reserve Masonic Comm Nursing home, Medina, OH, CCN 366240

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35093592OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Mar 13, 2019 Accepting new patients
Radiology Associates of Canton, Inc. Past Accepting new patients

Locations

525 E Market St
Akron, OH 44304
Phone (330) 375-6350

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

970 E Washington St
Ste 1C
Medina, OH 44256

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

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 10

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516233600000",
    "number": "1225156672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 WADSWORTH RD",
            "address_2": "SUITE D",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442818330",
            "telephone_number": "330-331-7106",
            "fax_number": "330-331-7556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 WADSWORTH RD",
            "address_2": "SUITE D",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442818330",
            "telephone_number": "330-331-7106",
            "fax_number": "330-331-7556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISTEL",
        "first_name": "LAURA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2018-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "OH",
            "license": "35093592",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35093592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3090926",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wadsworth, OH

Sources for this page

Verify at the official NPI Registry.