Individual provider Active NPI

Alyssa Koleda

  • Physician Assistant
  • Toledo, OH
National Provider Identifier
1366908162
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2409 Cherry St Ste 307
Toledo, OH 43608-2672
Phone
(419) 251-4873
NPI assigned
Feb 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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 Primary

Addresses

Primary practice location

2409 Cherry St Ste 307
Toledo, OH 43608-2672

Mailing address

2409 Cherry St Ste 307
Toledo, OH 43608-2672
Phone (419) 251-4873

Other names 1

  • Alyssa Kitts Former name

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
I20190408002537 OH Practitioner - Physician Assistant 3476894031 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
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

2409 Cherry St
Suite 307
Toledo, OH 43608-2672
Phone (419) 251-4873

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
  • Mercy Health - Defiance Hospital Hospital, Defiance, OH, CCN 360270
  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians North Specialty Care LLC Physician Assistant CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians - North, LLC CurrentSince Mar 13, 2019 Accepting new patients
Mercy Health Physicians-North LLC CurrentSince Mar 13, 2019 Accepting new patients

Locations

12623 Eckel Junction Rd
Perrysburg, OH 43551
Phone (567) 368-1434

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

2200 Jefferson Ave
Fl 5
Toledo, OH 43604
Phone (419) 251-9826

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

4126 N Holland Sylvania Rd
Ste 220
Toledo, OH 43623
Phone (419) 517-7600

2409 Cherry St
Ste 307
Toledo, OH 43608
Phone (419) 251-4696

Interoperability endpoints

  • Direct secure messaging: akitts589263@direct.bsmhealth.org

Organizations & group practices 3

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 4

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": "1550361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1366908162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2409 CHERRY ST STE 307",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082672",
            "telephone_number": "419-251-4873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 CHERRY ST STE 307",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082672",
            "telephone_number": "419-251-4873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLEDA",
        "first_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-17",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "KITTS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.