Individual provider Active NPI

Jill Ann Wasylik-Waldock, FNP

  • Family Nurse Practitioner
  • Sandusky, OH
National Provider Identifier
1508633660
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0034832 Issued in OH
Practice address
1111 Hayes Ave
Sandusky, OH 44870-3323
Phone
(419) 557-7455
Fax
(419) 557-7782
NPI assigned
Dec 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0034832 OH Primary
Family Nurse Practitioner 363LF0000X F08230498 OH

Addresses

Primary practice location

1111 Hayes Ave
Sandusky, OH 44870-3323

Mailing address

500 W Monroe St Ste 1300
Chicago, IL 60661-3704
Phone (877) 751-5783

Other practice location 1

4210 Whispering Pines Ln
Sandusky, OH 44870-7086
Phone (419) 239-6267

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
I20240528002041 OH Practitioner - Nurse Practitioner 6406298041 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ER-Doc IncGroup PAC ID 1658318977, 13 clinicians
North Coast Professional Company, LLCGroup PAC ID 6305810201, 105 clinicians

Practice addresses (Care Compare)

1111 Hayes Ave
Sandusky, OH 44870-3323
Phone (419) 557-7455

1470W McPherson Hwy
Clyde, OH 43410-1010
Phone (419) 547-0700

Hospital & facility affiliations

  • Firelands Regional Medical Center Hospital, Sandusky, OH, CCN 360025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0034832OHMDFamily Nurse Practitioner
F08230498OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Coast Professional Company, LLC CurrentSince Apr 24, 2024 Accepting new patients
North Coast Professional Company, LLC CurrentSince Apr 24, 2024 Accepting new patients
ER-Doc Inc CurrentSince Aug 2, 2025 Accepting new patients

Locations

1470 W McPherson Hwy
Clyde, OH 43410
Phone (419) 547-0700

703 Tyler St
Ste 352
Sandusky, OH 44870
Phone (419) 557-6785

1912 Hayes Ave
Ste 1
Sandusky, OH 44870

1111 Hayes Ave
Sandusky, OH 44870
Phone (419) 557-7455

5420 Milan Rd
Ste C
Sandusky, OH 44870
Phone (419) 557-6490

Interoperability endpoints

  • Direct secure messaging: jill.wasylik-waldock@fpg.medicity.net

Organizations & group practices 3

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 5

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": "1701993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1508633660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W MONROE ST STE 1300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606613704",
            "telephone_number": "877-751-5783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 HAYES AVE",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448703323",
            "telephone_number": "419-557-7455",
            "fax_number": "419-557-7782"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4210 Whispering Pines Ln",
            "address_purpose": "LOCATION",
            "city": "Sandusky",
            "state": "OH",
            "postal_code": "448707086",
            "country_code": "US",
            "telephone_number": "419-239-6267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASYLIK-WALDOCK",
        "first_name": "JILL",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-08",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0034832",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "F08230498",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

Verify at the official NPI Registry.