NPIMap

Individual provider Active NPI

Michelle M Bailey, PA-C

  • Surgical Physician Assistant
  • Chardon, OH
National Provider Identifier
1578003802
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
50.004977RX Issued in OH
Practice address
13170 Ravenna Road
Suite 200
Chardon, OH 44024
Phone
(844) 542-6363
Fax
(440) 279-1582
NPI assigned
Mar 6, 2017
Last updated
Mar 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 50.004977RX OH Primary

Addresses

Primary practice location

13170 Ravenna Road
Suite 200
Chardon, OH 44024

Mailing address

13170 Ravenna Rd #200
Suite 200
Chardon, OH 44024-4426
Phone (844) 542-6363

Other practice location 1

7590 Auburn Road
Suite 214
Concord Twp, OH 44077
Phone (844) 542-6363

Other practice location 2

25501 Chagrin Blvd.
Suite 200
Beachwood, OH 44122
Phone (844) 542-6363

Other identifiers 3

IdentifierTypeStateIssuer
0211306MedicaidOH
H507850OtherOHMEDICARE
H507851OtherOHMEDICARE

Other names 1

  • Michelle M. Ford Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address michelle.ford@lhpg.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170406002950 OH Practitioner - Physician Assistant 8426334319 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

158 W Main Rd
Conneaut, OH 44030-2039

25501 Chagrin Blvd
Suite 200
Beachwood, OH 44122-5603
Phone (844) 746-8537

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Hospital System, Inc CurrentSince Dec 31, 2018 Accepting new patients
University Primary Care Practices Inc CurrentSince Mar 1, 2025 Accepting new patients
University Primary Care Practices Inc CurrentSince Mar 1, 2025 Accepting new patients
University Primary Care Practices Past Accepting new patients

Locations

25501 Chagrin Blvd
Ste 200
Beachwood, OH 44122
Phone (330) 668-4050

13170 Ravenna Rd
Ste 200
Chardon, OH 44024
Phone (844) 542-6363

11100 Euclid Ave
Cleveland Heights, OH 44106

7590 Auburn Rd
Ste 214
Concord Township, OH 44077
Phone (844) 746-8537

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

10780 Kinsman Rd
Newbury, OH 44065
Phone (440) 564-5656

Interoperability endpoints

  • Direct secure messaging: mbailey28492@ehrdirect.uhhospitals.org
  • Direct secure messaging: michelle.ford@lhpg.eclinicaldirectplus.com

Organizations & group practices 7

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 8

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": "1488758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1578003802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13170 RAVENNA RD #200",
            "address_2": "SUITE 200",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440244426",
            "telephone_number": "844-542-6363",
            "fax_number": "440-279-1582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13170 RAVENNA ROAD",
            "address_2": "SUITE 200",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "44024",
            "telephone_number": "844-542-6363",
            "fax_number": "440-279-1582"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7590 Auburn Road",
            "address_2": "Suite 214",
            "address_purpose": "LOCATION",
            "city": "Concord Twp",
            "state": "OH",
            "postal_code": "44077",
            "country_code": "US",
            "telephone_number": "844-542-6363",
            "fax_number": "440-455-3073",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25501 Chagrin Blvd.",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Beachwood",
            "state": "OH",
            "postal_code": "44122",
            "country_code": "US",
            "telephone_number": "844-542-6363",
            "fax_number": "440-279-1582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "MICHELLE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-06",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50.004977RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0211306",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "H507850",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "H507851",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michelle.ford@lhpg.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Baseline West Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "13170 Ravenna Road",
            "address_2": "Suite 200",
            "city": "Chardon",
            "state": "OH",
            "country_code": "US",
            "postal_code": "44024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "FORD",
            "middle_name": "M.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chardon, OH

Sources for this page

Verify at the official NPI Registry.