Individual provider Active NPI

Domenica Zuccaro, A.A.

  • Anesthesiologist Assistant
  • Independence, OH
National Provider Identifier
1396825899
Registry record updated Feb 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
67.000121 Issued in OH
Practice address
6701 Rockside Rd
Suite 200
Independence, OH 44131-2358
Phone
(216) 674-5230
Fax
(216) 674-5231
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 67.000121 OH Primary

Addresses

Primary practice location

6701 Rockside Rd
Suite 200
Independence, OH 44131-2358

Mailing address

6701 Rockside Rd
Suite 200
Independence, OH 44131-2358
Phone (216) 674-5230

Other identifiers 1

IdentifierTypeStateIssuer
2696739MedicaidOH

Other names 1

  • Domenica Randau Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061113000412 OH Practitioner - Anesthesiology Assistant 2769480482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio Anesthesia Group, IncGroup PAC ID 9537222138, 130 clinicians

Practice addresses (Care Compare)

29017 Cedar Rd
Lyndhurst, OH 44124-4073
Phone (440) 460-8000

Merit-based Incentive Payment System (MIPS)

Final score
78.79 of 100Reported as group
Quality
71.01
Improvement activities
40
Cost
82.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
67.000121OHMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Anesthesia Group, Inc CurrentSince Dec 21, 2023 Accepting new patients

Locations

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

29017 Cedar Rd
Lyndhurst, OH 44124
Phone (440) 255-9920

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392076800000",
    "number": "1396825899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 ROCKSIDE RD",
            "address_2": "SUITE 200",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312358",
            "telephone_number": "216-674-5230",
            "fax_number": "216-674-5231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 ROCKSIDE RD",
            "address_2": "SUITE 200",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312358",
            "telephone_number": "216-674-5230",
            "fax_number": "216-674-5231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUCCARO",
        "first_name": "DOMENICA",
        "credential": "A.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2014-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "OH",
            "license": "67.000121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2696739",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOMENICA",
            "last_name": "RANDAU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Independence, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.