Individual provider Active NPI

Jonathan Dale Naticchia

  • Physician Assistant
  • Mentor, OH
National Provider Identifier
1437039591
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.009705 Issued in OH
Practice address
9110 Mentor Ave
Mentor, OH 44060-6404
Phone
(440) 701-8030
NPI assigned
Sep 8, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.009705 OH Primary

Addresses

Primary practice location

9110 Mentor Ave
Mentor, OH 44060-6404

Mailing address

17685 Creekside Dr
Chagrin Falls, OH 44023-5452

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
I20251027003689 OH Practitioner - Physician Assistant 3870082274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suhas LLCGroup PAC ID 7012337629, 5 clinicians

Practice addresses (Care Compare)

9110 Mentor Ave
Unit 9B
Mentor, OH 44060-6404
Phone (440) 701-8030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.009705OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Suhas LLC CurrentSince Sep 15, 2025 Accepting new patients
Suhas LLC PastSince Sep 14, 2025 Accepting new patients

Locations

9110 Mentor Ave
Unit 9B
Mentor, OH 44060
Phone (440) 701-8030

Organizations & group practices 2

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": "1757289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1437039591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17685 CREEKSIDE DR",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440235452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9110 MENTOR AVE",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440606404",
            "telephone_number": "440-701-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATICCHIA",
        "first_name": "JONATHAN",
        "middle_name": "DALE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-08",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.009705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

Verify at the official NPI Registry.