Individual provider Active NPI

Andrew Cole Haefele, PA-C

  • Medical Physician Assistant
  • Elyria, OH
National Provider Identifier
1407747371
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
50.009578RX Issued in OH
Practice address
630 E River St
Elyria, OH 44035-5902
Phone
(440) 329-7500
NPI assigned
Jul 10, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 50.009578RX OH Primary

Addresses

Primary practice location

630 E River St
Elyria, OH 44035-5902

Mailing address

634 Eastpointe CT
Amherst, OH 44001-3445
Phone (440) 656-9060

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
I20250820002380 OH Practitioner - Physician Assistant 7214436708 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emh Regional Medical CenterGroup PAC ID 7517931389, 14 clinicians
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians

Practice addresses (Care Compare)

630 E River St
Elyria, OH 44035-5902
Phone (440) 329-7500

630 E River St
Elyria, OH 44035-5981
Phone (440) 284-8600

Hospital & facility affiliations

  • University Hospitals - Elyria Medical Center Hospital, Elyria, OH, CCN 360145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50.009578RXOHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emh Regional Medical Center CurrentSince Aug 15, 2025 Accepting new patients
University Hospitals Medical Group Inc CurrentSince Dec 1, 2025 Accepting new patients
University Hospitals St. John Medical Center CurrentSince Aug 15, 2025 Accepting new patients
Emh Regional Medical Center CurrentSince Aug 15, 2025 Accepting new patients

Locations

8055 Mayfield Rd
Ste 105
Chesterland, OH 44026
Phone (440) 214-8024

11100 Euclid Ave
Cleveland Heights, OH 44106

630 E River St
Elyria, OH 44035
Phone (440) 329-7450

29000 Center Ridge Rd
Westlake, OH 44145
Phone (440) 414-6046

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 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": "1752105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1407747371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 EASTPOINTE CT",
            "city": "AMHERST",
            "state": "OH",
            "postal_code": "440013445",
            "telephone_number": "440-656-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 E RIVER ST",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440355902",
            "telephone_number": "440-329-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAEFELE",
        "first_name": "ANDREW",
        "middle_name": "COLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-10",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.009578RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

Verify at the official NPI Registry.