Paulette Kathleen Grant, P.A.C.
Individual provider Active NPI Medical Physician Assistant · Clyde, OH
NPI 1295763274 · NPPES record last updated Sep 21, 2018
Key facts
- NPI
- 1295763274
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 50-00-0434 (OH)
- Practice address
- 112 Independence Way Ste 110
Clyde, OH 43410-9812 - Phone
- (419) 483-9000
- Fax
- (419) 483-9003
- NPI assigned
- Jun 29, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 16
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cleveland Clinic
Practice addresses (Care Compare)
33300 Cleveland Clinic Blvd
Avon, OH 44011-1172
Phone (440) 695-5000
8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950
9500 Euclid Ave
Cleveland, OH 44195-0001
Hospital & facility affiliations
- Cleveland Clinic Avon Hospital
- Cleveland Clinic
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: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070702000009 | OH | Practitioner - Physician Assistant | 2860591922 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Hospitals St. John Medical Center | Current |
Accepting new patients | |
| The Cleveland Clinic Foundation | Current |
Accepting new patients | |
| The Cleveland Clinic Foundation | Current |
Accepting new patients |
Locations
9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270
29000 Center Ridge Rd
Westlake, OH 44145
Phone (440) 414-6046
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 50-00-0434 | OH | Yes |
Addresses
Primary practice location
112 Independence Way Ste 110
Clyde, OH 43410-9812
Mailing address
PO Box 378
Sandusky, OH 44871-0378
Phone (419) 609-1112
Other practice location 1
813 Northwest St
Bellevue, OH 44811-0123
Phone (419) 483-9000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50-00-0434 | Other | OH | PHYSICIAN ASSISTANT REG |
Other providers in Clyde, OH
- Brittany Nichole Fitzpatrick
- Taylor Nicole Flick
- Jayna Leigh Franks
- Stacey Frater-Koselke
- Dennis Gerard Furlong
- Gregg S. Griffin, D.C., Inc.
- Gregg Stephen Griffin
- Cassandra Gullett
- Katrice Hackenburg
- Joan Harding
All providers in Clyde, OH · Medical Physician Assistant in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 21, 2018. 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.
- 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.