Individual provider Active NPI

Rachael Passodelis, CPNP

  • Pediatric Nurse Practitioner
  • Akron, OH
National Provider Identifier
1417492992
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
020691 Issued in OH
Practice address
1 Perkins SQ
Akron, OH 44308-1063
Phone
(330) 543-1000
NPI assigned
Dec 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.405456 OH
Pediatric Nurse Practitioner 363LP0200X 020691 OH Primary

Addresses

Primary practice location

1 Perkins SQ
Akron, OH 44308-1063

Mailing address

One Perkins Square
Akron, OH 44308-1062
Phone (330) 543-1000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rweigand76896@direct.chmca.org

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
I20170630000548 OH Practitioner - Nurse Practitioner 4688943939 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
020691OHMDDentist
RN.405456OHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Medical Center of Akron Current Accepting new patients
Children'S Hospital Medical Center of Akron CurrentSince Jun 14, 2017 Accepting new patients
Akron Children'S Hospital Current Accepting new patients
Children'S Hospital Medical Center of Akron CurrentSince Jun 14, 2017 Accepting new patients

Locations

1 Perkins Sq
Akron, OH 44308
Phone (330) 543-8050

3733 Park East Dr
Ste 230
Beachwood, OH 44122
Phone (330) 543-8520

328 E Hines Hill Rd
Hudson, OH 44236
Phone (234) 867-6820

3778 Medina Rd
Medina, OH 44256
Phone (330) 543-0870

6076 Whipple Ave NW
North Canton, OH 44720
Phone (330) 433-1777

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.

NPI Registry JSON

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

{
    "created_epoch": "1482192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1417492992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE PERKINS SQUARE",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081062",
            "telephone_number": "330-543-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PERKINS SQ",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081063",
            "telephone_number": "330-543-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASSODELIS",
        "first_name": "RACHAEL",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-20",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.405456",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "020691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rweigand76896@direct.chmca.org",
            "affiliation": "N",
            "address_1": "1 Perkins Sq",
            "city": "Akron",
            "state": "OH",
            "country_code": "US",
            "postal_code": "443081063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.