Active NPI
Jonathan Dale Naticchia
- Physician Assistant
- Mentor, OH
National Provider Identifier
1437039591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 50.009705
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 50.009705 | OH | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Suhas LLC | Current | Accepting new patients | |
| Suhas LLC | Past | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.