Individual provider Active NPI

Rosanna O Zavarella, PHD

  • Psychologist
  • Beachwood, OH
National Provider Identifier
1306835269
Registry record updated May 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
P.5150 Issued in OH
Practice address
24100 Chagrin Blvd Ste 140
Beachwood, OH 44122-5545
Phone
(216) 321-3025
Fax
(216) 831-1269
NPI assigned
Oct 13, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X P.5150 OH Primary

Addresses

Primary practice location

24100 Chagrin Blvd Ste 140
Beachwood, OH 44122-5545

Mailing address

24100 Chagrin Blvd Ste 140
Beachwood, OH 44122-5545
Phone (216) 321-3025

Other practice location 1

8338 Tyler Blvd Fl 2
Mentor, OH 44060-4221
Phone (440) 205-5566

Other identifiers 1

IdentifierTypeStateIssuer
2271018MedicaidOH

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040405000109 OH Practitioner - Clinical Psychologist 2769475045 Practice locations: Beachwood, OH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

24100 Chagrin Blvd
Suite 140
Beachwood, OH 44122-5545
Phone (216) 321-3025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
P.5150OHMDPsychologist
5150OHMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1306835269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24100 CHAGRIN BLVD STE 140",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225545",
            "telephone_number": "216-321-3025",
            "fax_number": "216-831-1269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24100 CHAGRIN BLVD STE 140",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225545",
            "telephone_number": "216-321-3025",
            "fax_number": "216-831-1269"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8338 Tyler Blvd Fl 2",
            "address_purpose": "LOCATION",
            "city": "Mentor",
            "state": "OH",
            "postal_code": "440604221",
            "country_code": "US",
            "telephone_number": "440-205-5566",
            "fax_number": "216-831-1269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAVARELLA",
        "first_name": "ROSANNA",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "P.5150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2271018",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.