Individual provider Active NPI

Emily Herbruck, PA

  • Physician Assistant
  • Beachwood, OH
National Provider Identifier
1598403222
Registry record updated Jun 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3999 Richmond Rd
Beachwood, OH 44122-6046
Phone
(216) 593-5500
NPI assigned
May 23, 2022
Last updated
Jun 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary
Physician Assistant 363A00000X 6567 CT

Addresses

Primary practice location

3999 Richmond Rd
Beachwood, OH 44122-6046

Mailing address

3999 Richmond Rd
Beachwood, OH 44122-6046

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220728001895 OH Practitioner - Physician Assistant 7810379484 Reassigns benefits to 4 organizations
I20240828003687 CT Practitioner - Physician Assistant 7810379484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.26 of 100Reported as group
Quality
86.95
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
90.04 of 100Reported as group
Quality
85.63
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.38 of 100Reported as group
Quality
79.57
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6567CTMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Norwalk Hospital Association CurrentSince Sep 1, 2024 Accepting new patients
Norwalk Hospital Association CurrentSince Sep 1, 2024 Accepting new patients

Locations

520 West Ave
Norwalk, CT 06850
Phone (203) 852-2417

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.

NPI Registry JSON

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717200000000",
    "number": "1598403222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3999 RICHMOND RD",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441226046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3999 RICHMOND RD",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441226046",
            "telephone_number": "216-593-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBRUCK",
        "first_name": "EMILY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-23",
        "last_updated": "2024-06-01",
        "certification_date": "2024-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "6567",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.