Individual provider Active NPI

Sean Robert Nischwitz

  • Physician Assistant
  • Kent, OH
National Provider Identifier
1487379293
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.007858 Issued in OH
Practice address
411 Devon PL
Kent, OH 44240-6480
Phone
(330) 677-7681
NPI assigned
Oct 5, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.007858 OH Primary

Addresses

Primary practice location

411 Devon PL
Kent, OH 44240-6480

Mailing address

78 Hahns Way
Wadsworth, OH 44281-8499

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
I20221215002128 OH Practitioner - Physician Assistant 4981073855 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Urgent Care, LLCGroup PAC ID 3971985607, 109 clinicians

Practice addresses (Care Compare)

1005 E Main St
Suite 3
Kent, OH 44240-2815
Phone (330) 440-0360

16601 Chagrin Blvd
Shaker Heights, OH 44120-3719
Phone (216) 727-2010

2209 Crocker Rd
Suite D
Westlake, OH 44145-6727
Phone (440) 249-6060

2700 E Aurora Rd
Suite F
Twinsburg, OH 44087-6818
Phone (330) 476-5510

27520 Chagrin Blvd
Beachwood, OH 44122-4424
Phone (440) 809-8810

3909 Orange PL
Suite 2100
Beachwood, OH 44122-8400
Phone (440) 809-8810

5901 E Royalton Rd
Suite 1400B
Broadview Heights, OH 44147-3532
Phone (440) 499-5900

6140 Som Ctr Rd
Solon, OH 44139-2333
Phone (440) 578-0845

716 N Court St
Medina, OH 44256-1748
Phone (330) 426-8700

9449 State Route 14
Streetsboro, OH 44241-5225
Phone (330) 227-6640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.007858OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc CurrentSince Dec 5, 2022 Accepting new patients
University Primary Care Practices Inc CurrentSince Dec 5, 2022 Accepting new patients
University Hospitals Urgent Care, LLC CurrentSince Dec 5, 2022 Accepting new patients

Locations

3909 Orange Pl
Ste 2100
Beachwood, OH 44122
Phone (216) 896-1800

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

Interoperability endpoints

  • Direct secure messaging: snischwitz431282@ehrdirect.uhhospitals.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1487379293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 HAHNS WAY",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442818499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 DEVON PL",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442406480",
            "telephone_number": "330-677-7681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISCHWITZ",
        "first_name": "SEAN",
        "middle_name": "ROBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-05",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.007858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, OH

Sources for this page

Verify at the official NPI Registry.