Individual provider Active NPI

Anna Grzebieniak

  • Psychiatric/Mental Health Nurse Practitioner
  • Beachwood, OH
National Provider Identifier
1588085997
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
COA15846 Issued in OH
Practice address
25700 Science Park Dr
Beachwood, OH 44122-7319
Phone
(724) 971-3751
NPI assigned
Jan 2, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 379900 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X COA15846 OH Primary

Addresses

Primary practice location

25700 Science Park Dr
Beachwood, OH 44122-7319

Mailing address

17 Wilson Ave
Niles, OH 44446-1928

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
I20150604002051 OH Practitioner - Nurse Practitioner 0547581324 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
379900OHMDRegistered Nurse
COA15846OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Akron Children'S Hospital Current Accepting new patients
Family & Community Services, Inc CurrentSince Apr 21, 2015 Accepting new patients
Family & Community Services Inc CurrentSince Apr 21, 2015 Accepting new patients
Children'S Hospital Medical Center of Akron Past Accepting new patients
Tomas Psychological Services, Inc PastSince Feb 18, 2017 Accepting new patients

Locations

1 Perkins Sq
Akron, OH 44308
Phone (330) 543-8050

150 E Market St
Warren, OH 44481
Phone (330) 394-6244

318 Mahoning Ave NW
Warren, OH 44483
Phone (330) 394-6342

Interoperability endpoints

  • Direct secure messaging: agrzebieniak112916@direct.chmca.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1388620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1588085997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 WILSON AVE",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444461928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25700 SCIENCE PARK DR",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441227319",
            "telephone_number": "724-971-3751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRZEBIENIAK",
        "first_name": "ANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-02",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "379900",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "COA15846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.