Individual provider Active NPI

Sydney Elizabeth Hattendorf, PA-C

  • Physician Assistant
  • Oregon, OH
National Provider Identifier
1336788827
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50006086 Issued in OH
Practice address
2702 Navarre Ave Ste 320
Oregon, OH 43616-3224
Phone
(419) 696-5555
Fax
(419) 696-8499
NPI assigned
Dec 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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 50006086 OH Primary

Addresses

Primary practice location

2702 Navarre Ave Ste 320
Oregon, OH 43616-3224

Mailing address

2702 Navarre Ave Ste 320
Oregon, OH 43616-3224

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
I20200218003291 OH Practitioner - Physician Assistant 7416384128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians North Specialty Care LLCGroup PAC ID 1951707884, 345 clinicians

Practice addresses (Care Compare)

12623 Eckel Junction Rd
Perrysburg, OH 43551-1304
Phone (567) 368-1500

2600 Navarre Ave
Oregon, OH 43616-3207
Phone (419) 696-8877

2702 Navarre Ave
Oregon, OH 43616-3224

3900 Sunforest CT
Suite 240
Toledo, OH 43623-4481
Phone (419) 475-1600

Hospital & facility affiliations

  • Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112
  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068
  • Bay Park Community Hospital Hospital, Oregon, OH, CCN 360259
  • Mercy Health - Defiance Hospital Hospital, Defiance, OH, CCN 360270

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50006086OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians North Specialty Care LLC Physician Assistant CurrentSince Mar 25, 2024 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

2702 Navarre Ave
Ste 320
Oregon, OH 43616
Phone (419) 479-5795

2702 Navarre Ave
Ste 302
Oregon, OH 43616
Phone (419) 693-9727

12623 Eckel Junction Rd
Ste 2600
Perrysburg, OH 43551
Phone (567) 368-1490

3900 Sunforest Ct
Ste 240
Toledo, OH 43623
Phone (419) 472-3126

3425 Executive Pkwy
Ste 210
Toledo, OH 43606
Phone (419) 251-2360

Interoperability endpoints

  • Direct secure messaging: shattendorf2534039@direct.bsmhealth.org
  • Direct secure messaging: sydney.hattendorf@hpwo.directbygreenway.com

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 5

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": "1577750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1336788827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 NAVARRE AVE STE 320",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436163224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 NAVARRE AVE STE 320",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436163224",
            "telephone_number": "419-696-5555",
            "fax_number": "419-696-8499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATTENDORF",
        "first_name": "SYDNEY",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-31",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50006086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon, OH

Sources for this page

Verify at the official NPI Registry.