Active NPI
Agnieszka Anna Ardelt, M.D.
- Neurocritical Care Physician
- Cleveland, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurocritical Care Physician
- License
- 35132213
- Practice address
- 2500 Metrohealth Dr
Cleveland, OH 44109-1900 - Phone
- (216) 778-7800
- NPI assigned
- Apr 17, 2006
- Last updated
- Dec 17, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 036122485 | IL | |
| Neurology Physician | 2084N0400X | 35132213 | OH | |
| Vascular Neurology Physician | 2084V0102X | 35132213 | OH | |
| Vascular Neurology Physician | 2084V0102X | 036122485 | IL | |
| Neurocritical Care Physician | 2084A2900X | 35132213 | OH | Primary |
Addresses
Primary practice location
2500 Metrohealth Dr
Cleveland, OH 44109-1900
Mailing address
2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone (216) 778-7800
Other practice location 1
5841 S Maryland Ave
Chicago, IL 60637-1447
Phone (773) 702-1000
Other practice location 2
305 W Jackson St Ste 103
Carbondale, IL 62901-1474
Phone (618) 351-4972
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009937034 | Medicaid | AL | |
| 051534611 | Other | AL | BLUE CROSS |
| 009937033 | Medicaid | AL | |
| 051534612 | Other | AL | BLUE CROSS |
Other names 1
- Agnieszka Anna Ardelt
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | aardelt25510@sih.direct-ci.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Neurosurgery
- Education
- Washington University School of Medicine, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone (216) 778-7800
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036122485 | IL | MD | Neurology Physician |
| 35132213 | OH | MD | Vascular Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The University of Chicago Medical Center | Current | Accepting new patients | |
| The Metrohealth System | Current | Accepting new patients | |
| The University of Chicago Medical Center | Current | Accepting new patients | |
| The Metrohealth System | Current | Accepting new patients | |
| Southern Illinois Medical Services, NFP | Current | Accepting new patients | |
| The Metrohealth System | Current | Accepting new patients |
Locations
150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061
2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300
305 W Jackson St
Ste 103
Carbondale, IL 62901
Phone 6183514972 ext. 65869
2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348
4229 Pearl Rd
Cleveland, OH 44109
Phone (216) 459-6300
Interoperability endpoints
- aardelt134811@direct.metrohealth.org
- aardelt25510@sih.direct-ci.com
Organizations & group practices 6
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.
-
dba Metrohealth Professional Group
- Multi-Specialty Clinic/Center
- Cleveland, OH
- NPI 1053353896
-
dba SIH Medical Group
- Internal Medicine Physician
- Carbondale, IL
- NPI 1770656837
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1033218128
-
dba Metrohealth Medical Center
- General Acute Care Hospital
- Cleveland, OH
- NPI 1700828852
-
dba MetroHealth Brooklyn Memphis Pharmacy
- Pharmacy
- Cleveland, OH
- NPI 1992529911
-
dba UCMC Pharmacy Services
- Community/Retail Pharmacy
- Calumet City, IL
- NPI 1255895678
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Metrohealth Life Flight
- Air Ambulance
- Cleveland, OH
- NPI 1609043645
Hospital
-
dba Metrohealth Medical Center
- General Acute Care Hospital
- Cleveland, OH
- NPI 1700828852
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608163200000",
"number": "1568426427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 METROHEALTH DR",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441091900",
"telephone_number": "216-778-7800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 METROHEALTH DR",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441091900",
"telephone_number": "216-778-7800"
}
],
"practiceLocations": [
{
"address_1": "5841 S Maryland Ave",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606371447",
"country_code": "US",
"telephone_number": "773-702-1000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "305 W Jackson St Ste 103",
"address_purpose": "LOCATION",
"city": "Carbondale",
"state": "IL",
"postal_code": "629011474",
"country_code": "US",
"telephone_number": "618-351-4972",
"fax_number": "618-351-6522",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ARDELT",
"first_name": "AGNIESZKA",
"middle_name": "ANNA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-17",
"last_updated": "2020-12-17",
"certification_date": "2020-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "IL",
"license": "036122485",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "OH",
"license": "35132213",
"primary": false
},
{
"code": "2084V0102X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Vascular Neurology",
"state": "OH",
"license": "35132213",
"primary": false
},
{
"code": "2084V0102X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Vascular Neurology",
"state": "IL",
"license": "036122485",
"primary": false
},
{
"code": "2084A2900X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurocritical Care",
"state": "OH",
"license": "35132213",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009937034",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "051534611",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009937033",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "051534612",
"state": "AL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "aardelt25510@sih.direct-ci.com",
"affiliation": "N",
"address_1": "305 W Jackson St Ste 103",
"city": "Carbondale",
"state": "IL",
"country_code": "US",
"postal_code": "629011474",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "AGNIESZKA",
"last_name": "ARDELT",
"middle_name": "ANNA",
"credential": "MD",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.