Individual provider Active NPI

Caitlin M Stathopoulos, APRN

  • Nurse Practitioner
  • Medina, OH
National Provider Identifier
1477296010
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0030692 Issued in OH
Practice address
970 E Washington St
Medina, OH 44256-3332
Phone
(330) 721-5700
NPI assigned
Apr 20, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0030692 OH
Family Nurse Practitioner 363LF0000X 0030692 OH
Nurse Practitioner 363L00000X 0030692 OH Primary

Addresses

Primary practice location

970 E Washington St
Medina, OH 44256-3332

Mailing address

970 E Washington St
Medina, OH 44256-3332
Phone (330) 721-5700

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
I20220525000749 OH Practitioner - Nurse Practitioner 7214314608 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-5433

Hospital & facility affiliations

  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
  • Medina Hospital Hospital, Medina, OH, CCN 360091
  • Lodi Community Hospital Hospital, Lodi, OH, CCN 361303
  • Akron General Medical Center Hospital, Akron, OH, CCN 360027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0030692OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Milltown Family Physicians, Inc. CurrentSince May 22, 2022 Accepting new patients
The Cleveland Clinic Foundation CurrentSince May 15, 2024 Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

970 E Washington St
Medina, OH 44256
Phone (330) 723-7246

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

128 E Milltown Rd
Ste 105
Wooster, OH 44691
Phone (330) 345-8060

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1477296010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 E WASHINGTON ST",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442563332",
            "telephone_number": "330-721-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 E WASHINGTON ST",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442563332",
            "telephone_number": "330-721-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATHOPOULOS",
        "first_name": "CAITLIN",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-20",
        "last_updated": "2024-06-07",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "0030692",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0030692",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "0030692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

Verify at the official NPI Registry.