Individual provider Active NPI

Meredith B Gajda, CNP

  • Nurse Practitioner
  • Mentor, OH
National Provider Identifier
1326289794
Registry record updated Apr 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.09971 Issued in OH
Practice address
7956 Tyler Blvd
Mentor, OH 44060-4806
Phone
(440) 255-4455
Fax
(440) 255-4487
NPI assigned
Mar 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN.CNP.09971 OH Primary

Addresses

Primary practice location

7956 Tyler Blvd
Mentor, OH 44060-4806

Mailing address

7956 Tyler Blvd
Mentor, OH 44060-4806
Phone (440) 255-4455

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
I20090520000003 OH Practitioner - Nurse Practitioner 2567511629 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3004 Hayes Ave
Sandusky, OH 44870-5321
Phone (419) 609-1112

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.09971OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Hospital System, Inc Past Accepting new patients
Lake Hospital System Inc Nurse Practitioner Past Accepting new patients
Lake Hospital System Past Accepting new patients
Lake Hospital System Inc. Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1326289794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7956 TYLER BLVD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604806",
            "telephone_number": "440-255-4455",
            "fax_number": "440-255-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7956 TYLER BLVD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604806",
            "telephone_number": "440-255-4455",
            "fax_number": "440-255-4487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAJDA",
        "first_name": "MEREDITH",
        "middle_name": "B",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-16",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.09971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

Verify at the official NPI Registry.