Individual provider Active NPI

Lauren Nicole Mientkiewicz, DO

  • Pediatrics Physician
  • Akron, OH
National Provider Identifier
1356607212
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
34.011624 Issued in OH
Practice address
1 Perkins SQ
Akron, OH 44308-1063
Phone
(330) 543-8452
Fax
(330) 543-3761
NPI assigned
Apr 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 34.011624 OH Primary

Addresses

Primary practice location

1 Perkins SQ
Akron, OH 44308-1063

Mailing address

1 Perkins SQ
Akron, OH 44308-1063
Phone (330) 543-8452

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150611001794 OH Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 9032430384 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.011624OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professional Services, Inc. CurrentSince Jul 2, 2015 Accepting new patients
Children'S Hospital Medical Center of Akron Current Accepting new patients
Children'S Hospital Medical Center of Akron CurrentSince Jun 1, 2016 Accepting new patients
Children'S Hospital Medical Center of Akron Pediatrics CurrentSince Jun 1, 2016 Accepting new patients
The Cleveland Clinic Foundation CurrentSince May 27, 2015 Accepting new patients

Locations

1 Perkins Sq
Akron, OH 44308
Phone (330) 543-8050

36901 American Way
Avon, OH 44011
Phone (440) 930-6200

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

850 Columbia Rd
Ste 105
Westlake, OH 44145
Phone (440) 250-5737

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": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1356607212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PERKINS SQ",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081063",
            "telephone_number": "330-543-8452",
            "fax_number": "330-543-3761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PERKINS SQ",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081063",
            "telephone_number": "330-543-8452",
            "fax_number": "330-543-3761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIENTKIEWICZ",
        "first_name": "LAUREN",
        "middle_name": "NICOLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-04",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "34.011624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.