Individual provider Active NPI

Lindsey Ann Atanasov

  • Medical Physician Assistant
  • Wooster, OH
National Provider Identifier
1568176451
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
50.008813RX Issued in OH
Practice address
1761 Beall Ave
Wooster, OH 44691-2342
Phone
(330) 263-8100
NPI assigned
Jan 6, 2023
Last updated
Jun 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 50.008813RX OH Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1761 Beall Ave
Wooster, OH 44691-2342

Mailing address

275 Eastland Rd
Berea, OH 44017-2005

Other practice location 1

275 Eastland Rd
Berea, OH 44017-2005
Phone (440) 826-8012

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
I20240723003977 OH Practitioner - Physician Assistant 9436695772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3201 Enterprise Pkwy
Suite 370
Beachwood, OH 44122-7337

PO Box
Cleveland, OH 44192

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.008813RXOHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lawrence M. Stallings, MD, LTD Past Accepting new patients
Baldwin Wallace University PastSince Jan 1, 2023 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lindsey.atanasov@bloomingtonmedical.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1672963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1568176451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 EASTLAND RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440172005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 BEALL AVE",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912342",
            "telephone_number": "330-263-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 Eastland Rd",
            "address_purpose": "LOCATION",
            "city": "Berea",
            "state": "OH",
            "postal_code": "440172005",
            "country_code": "US",
            "telephone_number": "440-826-8012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATANASOV",
        "first_name": "LINDSEY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-06",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.008813RX",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

Verify at the official NPI Registry.