Debora Petani, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.006079 Issued in OH

Practice address

630 E River St
Elyria, OH 44035-5902

Phone

(440) 329-7500

NPI assigned

Jan 28, 2020

Last updated

Jan 28, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cleveland Clinic Avon HospitalGroup PAC ID 0547552630, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cleveland Clinic Avon Hospital Hospital, Avon, OH, CCN 360364
• Cleveland Clinic Hospital, Cleveland, OH, CCN 360180

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Cleveland Clinic Avon Hospital

  • General Acute Care Hospital
  • Avon, OH
  • NPI 1346607017
  Medicare reassignment Care Compare group
• Emh Regional Medical Center

  dba University Hospitals Elyria Medical Center

  • General Acute Care Hospital
  • Elyria, OH
  • NPI 1841299039
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cleveland Clinic Avon Hospital

  • General Acute Care Hospital
  • Avon, OH
  • NPI 1346607017
  Care Compare affiliation
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Care Compare affiliation

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1467083501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 ELBUR AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441074727",
            "telephone_number": "216-703-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 E RIVER ST",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440355902",
            "telephone_number": "440-329-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETANI",
        "first_name": "DEBORA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-28",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.006079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Pecsok
• Abraham O Pedro, MD
• Elba Perez
• Jerome Lee Perkins
• Jonathan Perry
• Lisa Christine Petrov, DDS
• Nelson Mark Petrov, DDS
• Erin Nicole Phillips, M.A., L.P.C
• Jason Matthew Phillips, MH COUNSELOR INTERN
• Sharvelle Phillips

• Physician Assistant in Elyria, OH
• Providers in Elyria, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.