Individual provider Active NPI

Cheryl Lynn Katavich, PA-C

  • Physician Assistant
  • Cleveland, OH
National Provider Identifier
1295089266
Registry record updated Oct 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.003657 Issued in OH
Practice address
9500 Euclid Ave
Crile Building, A90
Cleveland, OH 44195-0001
Phone
(330) 212-1980
NPI assigned
Oct 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2012

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 50.003657 OH Primary

Addresses

Primary practice location

9500 Euclid Ave
Crile Building, A90
Cleveland, OH 44195-0001

Mailing address

8000 Aileen Dr
Mentor, OH 44060-7304
Phone (330) 212-1980

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
I20130109000131 OH Practitioner - Physician Assistant 7113170838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ashtabula County Medical CenterGroup PAC ID 2668465600, 70 clinicians

Practice addresses (Care Compare)

2420 Lake Ave
Ashtabula, OH 44004-4954
Phone (440) 997-6969

2422 Lake Ave
Ashtabula, OH 44004-4985
Phone (440) 997-6969

Hospital & facility affiliations

  • Ashtabula County Medical Center Hospital, Ashtabula, OH, CCN 360125
  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ashtabula County Medical Center CurrentSince Apr 14, 2014 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients

Locations

2422 Lake Ave
Ashtabula, OH 44004
Phone (440) 992-4422

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

234 N Chestnut St
Jefferson, OH 44047
Phone (440) 576-8933

Interoperability endpoints

  • Direct secure messaging: pkatavich169558@direct.ccf.org

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 2

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": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351641600000",
    "number": "1295089266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 AILEEN DR",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440607304",
            "telephone_number": "330-212-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "address_2": "CRILE BUILDING, A90",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "330-212-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATAVICH",
        "first_name": "CHERYL",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.