Individual provider Active NPI

Desiree A Mouhlas, MMS, PA-C

  • Physician Assistant
  • Strongsville, OH
National Provider Identifier
1376166165
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
18303 Fox Hollow Dr
Strongsville, OH 44136-6110
Phone
(440) 476-5523
NPI assigned
May 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2020

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

18303 Fox Hollow Dr
Strongsville, OH 44136-6110

Mailing address

18303 Fox Hollow Dr
Strongsville, OH 44136-6110
Phone (440) 476-5523

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
I20210428002464 OH Practitioner - Physician Assistant 9436568623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview HospitalGroup PAC ID 4688571730, 74 clinicians

Practice addresses (Care Compare)

10654 Lorain Ave
Cleveland, OH 44111-5411
Phone (216) 941-1044

18101 Lorain Ave
Cleveland, OH 44111-5612
Phone (216) 476-7000

Hospital & facility affiliations

  • Fairview Hospital Hospital, Cleveland, OH, CCN 360077

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Hospital Physician Assistant CurrentSince Jan 15, 2024 Accepting new patients

Locations

10654 Lorain Ave
Cleveland, OH 44111
Phone (216) 941-1044

Organizations & group practices 1

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 1

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": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1376166165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18303 FOX HOLLOW DR",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441366110",
            "telephone_number": "440-476-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18303 FOX HOLLOW DR",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441366110",
            "telephone_number": "440-476-5523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUHLAS",
        "first_name": "DESIREE",
        "middle_name": "A",
        "name_prefix": "Miss",
        "credential": "MMS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-27",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Strongsville, OH

Sources for this page

Verify at the official NPI Registry.