Individual provider Active NPI

Jeannine Louise Marong, PA-C

  • Medical Physician Assistant
  • Cleveland, OH
National Provider Identifier
1508167172
Registry record updated Jul 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
003188 Issued in OH
Practice address
9500 Euclid Ave
Cleveland, OH 44195-0001
Phone
(216) 444-0261
NPI assigned
Nov 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 003188 OH Primary

Addresses

Primary practice location

9500 Euclid Ave
Cleveland, OH 44195-0001

Mailing address

5455 N Marginal Rd
Apartment #328
Cleveland, OH 44114-3937

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
I20101230000130 OH Practitioner - Physician Assistant 7911195227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians
Menorah Park Center for Senior LivingGroup PAC ID 3577469444, 79 clinicians

Practice addresses (Care Compare)

20050 Harvard Ave
Warrensville Heights, OH 44122-6800

26900 Cedar Rd
Beachwood, OH 44122-1191
Phone (216) 839-3000

27100 Cedar Rd
Beachwood, OH 44122-1109

29800 Bainbridge Rd
Solon, OH 44139-2202
Phone (216) 444-6568

6770 Mayfield Rd
Cleveland, OH 44124-2299
Phone (440) 461-6430

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

Hospital & facility affiliations

  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
  • Hillcrest Hospital Hospital, Mayfield Heights, OH, CCN 360230
  • South Pointe Hospital Hospital, Warrensville Heights, OH, CCN 360144
  • Euclid Hospital Hospital, Euclid, OH, CCN 360082

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
003188OHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Nov 13, 2010 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Nov 13, 2010 Accepting new patients

Locations

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

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": "1289520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341878400000",
    "number": "1508167172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5455 N MARGINAL RD",
            "address_2": "APARTMENT #328",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441143937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-444-0261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARONG",
        "first_name": "JEANNINE",
        "middle_name": "LOUISE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-12",
        "last_updated": "2012-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "003188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.