Individual provider Active NPI

Angela Gellings Mardula, PA

  • Physician Assistant
  • Mayfield Heights, OH
National Provider Identifier
1265487391
Registry record updated Jul 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
6780 Mayfield Rd
Mayfield Heights, OH 44124
Phone
(440) 312-4600
NPI assigned
May 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2018

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 Primary

Addresses

Primary practice location

6780 Mayfield Rd
Mayfield Heights, OH 44124

Mailing address

11800 Julie Dr
Chardon, OH 44024-8484
Phone (440) 214-9546

Other practice location 1

13951 Terrace Rd
East Cleveland, OH 44112-4308
Phone (216) 761-3300

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
I20040203000551 OH Practitioner - Physician Assistant 9234022468 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Sep 23, 2015 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Sep 23, 2015 Accepting new patients
Emergency Professionals of Ohio, Inc. Physician Assistant Past Accepting new patients

Locations

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

18901 Lake Shore Blvd
Euclid, OH 44119
Phone (216) 531-9000

6780 Mayfield Rd
Mayfield Hts, OH 44124
Phone (440) 331-9520

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

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

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532649600000",
    "number": "1265487391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 JULIE DR",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440248484",
            "telephone_number": "440-214-9546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6780 MAYFIELD RD",
            "city": "MAYFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "44124",
            "telephone_number": "440-312-4600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13951 Terrace Rd",
            "address_purpose": "LOCATION",
            "city": "East Cleveland",
            "state": "OH",
            "postal_code": "441124308",
            "country_code": "US",
            "telephone_number": "216-761-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GELLINGS MARDULA",
        "first_name": "ANGELA",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2018-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield Heights, OH

Sources for this page

Verify at the official NPI Registry.