City of Mentor on the Lake

Primary specialty

AmbulanceTaxonomy code 341600000X

Legal business name

CITY OF MENTOR ON THE LAKE

Practice address

5860 Andrews Rd
Mentor on the Lake, OH 44060-2827

Phone

(440) 257-7216

Fax

(440) 257-2766

NPI assigned

Sep 23, 2005

Last updated

Sep 1, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James Pechatsko

Title

Chief

Phone

(440) 257-7223

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630454400000",
    "number": "1376539437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 392907",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152519907",
            "telephone_number": "800-962-1484",
            "fax_number": "513-772-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5860 ANDREWS RD",
            "city": "MENTOR ON THE LAKE",
            "state": "OH",
            "postal_code": "440602827",
            "telephone_number": "440-257-7216",
            "fax_number": "440-257-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF MENTOR ON THE LAKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-23",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A",
        "authorized_official_last_name": "PECHATSKO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "440-257-7223"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590013209",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000155996",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2096486",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaleb Baynes
• Margaret Elizabeth Beyer, PHARMD
• Amy Bileci, LPN
• Connor Burger
• Alexis Renee Cardinale
• Jaliah Nicole Clisby
• Todd Colao, ATC
• Pamela Jean Daly, OTR/L
• Jill Degraff-Kuhen, LPN
• Danielle Dickerson, RN

• Ambulance in Mentor on the Lake, OH
• Providers in Mentor on the Lake, OH by specialty
• Ambulance in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.