Paul M Jerdonek, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3609 Issued in OH

Practice address

8748 Brecksville Rd
Ste 222
Brecksville, OH 44141-1985

Phone

(216) 839-2273

Fax

(216) 896-0735

NPI assigned

Nov 7, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/psychologyconsultantsinc/r4/
• FHIR API: https://api.qualifacts.org/api/fhir/summit-psychological/r4/

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.

• Psychology Consultants Inc

  • Clinical Social Worker
  • Medina, OH
  • NPI 1205882941
  NPD (past)
• Summit Psychological Associates, Inc.

  • Clinical Psychologist
  • Akron, OH
  • NPI 1114976701
  NPD (past)

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457332660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3591 RESERVE COMMONS DR STE 301",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565334",
            "telephone_number": "330-764-7916",
            "fax_number": "330-723-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8748 BRECKSVILLE RD",
            "address_2": "STE 222",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441411985",
            "telephone_number": "216-839-2273",
            "fax_number": "216-896-0735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERDONEK",
        "first_name": "PAUL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "3609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0382036",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George E. Jaskiw, M.D.
• Melanie Marie Jatsek, RD,LD
• Fauzia Javaheri
• Kathleen Jee, M.D.
• Jennings Center for Older Adults
• Toni Johnson, MSW
• Megan Johnston, LSW
• Amy Maya Kamath, SLP
• Boris Alexander Karaman, MD
• Kaitlynn Karthan, OTR/L

• Psychologist in Brecksville, OH
• Providers in Brecksville, OH by specialty
• Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.