Individual provider Active NPI

Andrea D Preston, M.D.

  • Pediatrics Physician
  • Avon, OH
National Provider Identifier
1558450460
Registry record updated Jun 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35.099262 Issued in OH
Practice address
36901 American Way
Avon, OH 44011-4057
Phone
(440) 899-5550
NPI assigned
Oct 11, 2006
Last updated
Jun 16, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 28169 SC
Pediatrics Physician 208000000X 2008-00353 NC
Pediatrics Physician 208000000X 35.099262 OH Primary

Addresses

Primary practice location

36901 American Way
Avon, OH 44011-4057

Mailing address

80 Maplecliff Dr
Avon Lake, OH 44012-1621
Phone (828) 989-3076

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120706000394 OH Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 4789849233 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2008-00353NCMDPediatrics Physician
35.099262OHMDPediatrics Physician
28169SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
The Cleveland Clinic Foundation CurrentSince Jun 12, 2012 Accepting new patients
The Cleveland Clinic Foundation Past Accepting new patients

Locations

36901 American Way
Avon, OH 44011
Phone (440) 930-6200

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

Interoperability endpoints

  • Direct secure messaging: apreston165460@direct.ccf.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339804800000",
    "number": "1558450460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 MAPLECLIFF DR",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440121621",
            "telephone_number": "828-989-3076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36901 AMERICAN WAY",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440114057",
            "telephone_number": "440-899-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTON",
        "first_name": "ANDREA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2012-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "28169",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2008-00353",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.099262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, OH

Sources for this page

Verify at the official NPI Registry.