Individual provider Active NPI

Judy Mindzora

  • Nurse Practitioner
  • Concord TWP, OH
National Provider Identifier
1578075321
Registry record updated Nov 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.021538 Issued in OH
Practice address
7590 Auburn Rd
Concord TWP, OH 44077-9176
Phone
(440) 354-1899
Fax
(440) 351-1845
NPI assigned
Nov 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN.CNP.021538 OH Primary

Addresses

Primary practice location

7590 Auburn Rd
Concord TWP, OH 44077-9176

Mailing address

5372 Lenore Dr
Mentor, OH 44060-1652
Phone (440) 440-7499

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
I20180227003321 OH Practitioner - Nurse Practitioner 4688935091 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians
Lake Hospital System, Inc.Group PAC ID 6002713922, 92 clinicians

Practice addresses (Care Compare)

36000 Euclid Ave
Willoughby, OH 44094-4625
Phone (216) 844-3800

36100 Euclid Ave
Suite 170
Willoughby, OH 44094-4475
Phone (440) 602-6737

Hospital & facility affiliations

  • Lake Health Hospital, Concord, OH, CCN 360098
  • Uh Cleveland Medical Center Hospital, Cleveland, OH, CCN 360137

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Hospital System, Inc CurrentSince Dec 19, 2017 Accepting new patients
Lake Hospital System Inc Nurse Practitioner CurrentSince Dec 19, 2017 Accepting new patients

Locations

7590 Auburn Rd
Concord Township, OH 44077
Phone (440) 354-1899

7590 Auburn Rd
Ste 14
Concord Township, OH 44077
Phone (440) 354-1899

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

36100 Euclid Ave
Ste 170
Willoughby, OH 44094
Phone (440) 602-6737

36000 Euclid Ave
Willoughby Hills, OH 44094
Phone (440) 375-8166

Interoperability endpoints

  • Direct secure messaging: jmindzora28269@ehrdirect.uhhospitals.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 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": "1509580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509580800000",
    "number": "1578075321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5372 LENORE DR",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440601652",
            "telephone_number": "440-440-7499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7590 AUBURN RD",
            "city": "CONCORD TWP",
            "state": "OH",
            "postal_code": "440779176",
            "telephone_number": "440-354-1899",
            "fax_number": "440-351-1845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINDZORA",
        "first_name": "JUDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-02",
        "last_updated": "2017-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.021538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord TWP, OH

Sources for this page

Verify at the official NPI Registry.