Marc Robert Pagano, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3320 Issued in OH

Practice address

11528 Royalton Rd
Suite 101
North Royalton, OH 44133-4469

Phone

(440) 582-3310

Fax

(440) 582-3310

NPI assigned

May 21, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  OH

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302566400000",
    "number": "1457560054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11528 ROYALTON RD",
            "address_2": "SUITE 101",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441334469",
            "telephone_number": "440-582-3310",
            "fax_number": "440-582-3310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11528 ROYALTON RD",
            "address_2": "SUITE 101",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441334469",
            "telephone_number": "440-582-3310",
            "fax_number": "440-582-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGANO",
        "first_name": "MARC",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2011-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "3320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0674453",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "160013",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL OF OHIO",
            "identifier": "341485124",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ohio CVS Stores LLC
• Ohio Wound Care Associates LLC
• Jean M Orehek-Dreyer, O.D.
• Joseph A Oriti, D.P.M.
• Morgan E Otto, APRN
• Palmentera & Associates, Inc.
• Carmela M. Palmentera, PH.D.
• Mark Paly, DMD
• Manbir Kaur Pannu, DDS
• Samuel G Papandreas, DDS MS

• Clinical Psychologist in North Royalton, OH
• Providers in North Royalton, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2011; 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.

Verify at the official NPI Registry.