Individual provider Active NPI

Paul Serwatka, APRN

  • Family Nurse Practitioner
  • Cleveland, OH
National Provider Identifier
1255154753
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0038031 Issued in OH
Practice address
17876 Saint Clair Ave
Cleveland, OH 44110-2602
Phone
(216) 403-9495
NPI assigned
Nov 4, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0038031 OH Primary

Addresses

Primary practice location

17876 Saint Clair Ave
Cleveland, OH 44110-2602

Mailing address

1798 Settlers Reserve Oval
Westlake, OH 44145-2046
Phone (216) 789-5457

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
I20241127000772 OH Practitioner - Nurse Practitioner 3678008604 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0038031OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stein Hospice Services, Inc CurrentSince Sep 12, 2024 Accepting new patients
Hospice of the Western Reserve at University Hospitals, LLC CurrentSince Sep 12, 2024 Accepting new patients
Stein Hospice Services, Inc CurrentSince Sep 12, 2024 Accepting new patients

Locations

17876 Saint Clair Ave
Cleveland, OH 44110
Phone (216) 383-2222

17876 Saint Clair Ave
Ste 102
Cleveland, OH 44110
Phone (216) 701-0736

1200 Sycamore Line
Sandusky, OH 44870
Phone (419) 625-5269

Organizations & group practices 4

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": "1730678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1255154753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1798 SETTLERS RESERVE OVAL",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441452046",
            "telephone_number": "216-789-5457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17876 SAINT CLAIR AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441102602",
            "telephone_number": "216-403-9495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERWATKA",
        "first_name": "PAUL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0038031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.