Individual provider Active NPI

Roger G Espinosa, MD

  • Interventional Cardiology Physician
  • Mentor, OH
National Provider Identifier
1386622728
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
35.053714 Issued in OH
Practice address
9485 Mentor Ave Ste 103
Mentor, OH 44060-8722
Phone
(440) 354-7300
Fax
(440) 354-7301
NPI assigned
Jan 5, 2006
Last updated
May 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 35.053714 OH Primary

Addresses

Primary practice location

9485 Mentor Ave Ste 103
Mentor, OH 44060-8722

Mailing address

PO Box 983
Mentor, OH 44061-0983
Phone (440) 354-7300

Other identifiers 2

IdentifierTypeStateIssuer
0629574MedicaidOH
2949519MedicaidOH

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
I20090507000090 OH Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 6709806250

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
24.22 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
80.74

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Roger Espinosa, M.D., LLC Cardiovascular Disease CurrentSince May 1, 2009 Accepting new patients
Ahmad Banna, M.D., LLC Current Accepting new patients
Atrium Medical Group, Inc Past Accepting new patients
Lake Heart Center LLC Interventional Cardiology PastSince Feb 1, 2016 Accepting new patients

Locations

9485 Mentor Ave
Ste 103
Mentor, OH 44060
Phone (440) 205-5799

9500 Mentor Ave
Ste 240
Mentor, OH 44060
Phone (440) 354-7300

124 Liberty St
Painesville, OH 44077
Phone (440) 352-4956

124 Liberty St
Ste B
Painesville, OH 44077
Phone (216) 352-4956

Interoperability endpoints

  • Direct secure messaging: respinosa218709@ehrdirect.uhhospitals.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1386622728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 983",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440610983",
            "telephone_number": "440-354-7300",
            "fax_number": "440-354-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9485 MENTOR AVE STE 103",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440608722",
            "telephone_number": "440-354-7300",
            "fax_number": "440-354-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPINOSA",
        "first_name": "ROGER",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OH",
            "license": "35.053714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0629574",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2949519",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

Verify at the official NPI Registry.