John J Baniewicz, MD
Individual provider Active NPI Internal Medicine Physician · Mentor, OH
NPI 1285740530 · NPPES record last updated Mar 1, 2021
Key facts
- NPI
- 1285740530
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 35-058500 (OH)
- Practice address
- 9485 Mentor Ave
Ste 210
Mentor, OH 44060 - Phone
- (440) 205-5835
- Fax
- (440) 205-5735
- NPI assigned
- Aug 21, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 10
Owned or controlled facilities with NPI records 2
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Northeastern Ohio University College of Medicine, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lake Hospital System, Inc.
Practice addresses (Care Compare)
9485 Mentor Ave
Suite 210
Mentor, OH 44060-8723
Phone (440) 205-5835
Hospital & facility affiliations
- Caretenders
- University Hospital Home Care Services, Inc
- Always Best Care Cleveland South
- Elara Caring
- Lake Health
- Uh Cleveland Medical Center
- Uh Regional Hospitals
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| Lake Health |
Hospital | Corporate Officer W-2 Managing Employee |
Dec 4, 2014 Dec 4, 2014 |
| Lake Health Center for Geriatric Psychiatry |
Hospital | Corporate Officer W-2 Managing Employee |
Dec 4, 2014 Dec 4, 2014 |
| Lake Health |
Hospital | Corporate Officer W-2 Managing Employee |
Dec 4, 2014 Dec 4, 2014 |
| Lake Health Beachwood Medical Center |
Hospital | Corporate Director | Dec 12, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040108000322 | OH | Practitioner - Internal Medicine | 0143129114 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35-058500 | OH | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Hospital System, Inc | Internal Medicine | Current |
Accepting new patients |
| Lake Hospital System, Inc | Internal Medicine | Current |
Accepting new patients |
| Lake Hospital System Inc | Internal Medicine | Current | Accepting new patients |
Locations
9485 Mentor Ave
Ste 210
Mentor, OH 44060
Phone (440) 205-5835
10780 Kinsman Rd
Newbury, OH 44065
Phone (440) 564-5656
36100 Euclid Ave
Ste 240
Willoughby, OH 44094
Phone (216) 953-6294
36000 Euclid Ave
Willoughby Hills, OH 44094
Phone (440) 375-8166
Interoperability endpoints
- jbaniewicz87090@ehrdirect.uhhospitals.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35-058500 | OH | Yes |
Addresses
Primary practice location
9485 Mentor Ave
Ste 210
Mentor, OH 44060
Mailing address
36000 Euclid Ave
Mso
Willoughby, OH 44094
Phone (440) 953-6082
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0854160 | Medicaid | OH |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | john.baniewicz@lhpg.eclinicaldirectplus.com | Direct |
Other providers in Mentor, OH
- John Balish
- Bethany Ball
- Amanda Irene Balzano
- Courtney Danielle Banghart
- John Christopher Baniewicz
- Christine Banks-Vanallen
- Nicole R Banning
- Cheryl M Barber
- Doreen L. Barlow
- Danielle Nichole Barnes
All providers in Mentor, OH · Internal Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 1, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.