Individual provider Active NPI

Amy M Mikusa, APRN CNP

  • Gerontology Nurse Practitioner
  • Stow, OH
National Provider Identifier
1285034116
Registry record updated Feb 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
COA. 16284-NP Issued in OH
Practice address
2971 Graham Rd
Stow, OH 44224-3619
Phone
(330) 688-7981
Fax
(330) 688-7469
NPI assigned
Aug 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X COA. 16284-NP OH Primary

Addresses

Primary practice location

2971 Graham Rd
Stow, OH 44224-3619

Mailing address

2971 Graham Rd
Stow, OH 44224-3619
Phone (330) 688-7981

Other practice location 1

21 E State St Ofc 233
Columbus, OH 43215-4281
Phone (888) 731-8994

Other identifiers 1

IdentifierTypeStateIssuer
0109397MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amy.mikusa@chci.eclinicaldirectplus.com Community Health Care Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1193 Norton Ave
Suite a
Norton, OH 44203-9526

Hospital & facility affiliations

  • Summa Health System Hospital, Akron, OH, CCN 360020
  • Akron General Medical Center Hospital, Akron, OH, CCN 360027
  • Summa Western Reserve Hospital Hospital, Cuyahoga Falls, OH, CCN 360150

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA. 16284-NPOHMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Care Inc. CurrentSince Mar 2, 2015 Accepting new patients
Radiology Associates of Canton, Inc. Past Accepting new patients

Locations

944 Cherry St E
Canal Fulton, OH 44614
Phone (330) 854-4281

1193 Norton Ave
Ste A
Norton, OH 44203
Phone (330) 825-0847

2971 Graham Rd
Stow, OH 44224
Phone (330) 688-7981

Interoperability endpoints

  • Direct secure messaging: amy.mikusa@chci.eclinicaldirectplus.com

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 5

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": "1409184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770336000000",
    "number": "1285034116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2971 GRAHAM RD",
            "city": "STOW",
            "state": "OH",
            "postal_code": "442243619",
            "telephone_number": "330-688-7981",
            "fax_number": "330-688-7469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2971 GRAHAM RD",
            "city": "STOW",
            "state": "OH",
            "postal_code": "442243619",
            "telephone_number": "330-688-7981",
            "fax_number": "330-688-7469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 E State St Ofc 233",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432154281",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIKUSA",
        "first_name": "AMY",
        "middle_name": "M",
        "credential": "APRN CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-28",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "COA. 16284-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0109397",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amy.mikusa@chci.eclinicaldirectplus.com",
            "affiliation": "Y",
            "affiliationName": "Community Health Care Inc.",
            "address_1": "2971 Graham Rd",
            "city": "Stow",
            "state": "OH",
            "country_code": "US",
            "postal_code": "442243619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stow, OH

Sources for this page

Verify at the official NPI Registry.