Molly Nicole Verhoff, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.004868RX Issued in OH

Practice address

5783 Wooster Pike
Medina, OH 44256-8816

Phone

(330) 725-0569

Fax

(330) 662-0258

NPI assigned

May 15, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR, OH2 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

Specialty

Physician Assistant

Education

Oregon Health Sciences University School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Dermatology and Cosmetic Surgery CenterGroup PAC ID 2264439181, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mverhoff@northeastskin.emadirect.md

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.

• Northeast Dermatology and Cosmetic Surgery Center

  • Dermatology Physician
  • Gahanna, OH
  • NPI 1609882836
  Medicare reassignment Care Compare group
• Advanced Dermatology of Oregon PC

  • Dermatology Physician
  • Tualatin, OR
  • NPI 1215035332
  Medicare reassignment
• Blue Ridge Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Arrington, VA
  • NPI 1518945187
  NPD (past)

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

{
    "created_epoch": "1431648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604102400000",
    "number": "1609254192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5783 WOOSTER PIKE",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442568816",
            "telephone_number": "330-725-0569",
            "fax_number": "330-662-0258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5783 WOOSTER PIKE",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442568816",
            "telephone_number": "330-725-0569",
            "fax_number": "330-662-0258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5779 Wooster Pike",
            "address_purpose": "LOCATION",
            "city": "Medina",
            "state": "OH",
            "postal_code": "442568816",
            "country_code": "US",
            "telephone_number": "330-725-0569",
            "fax_number": "330-662-0258",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2865 Center Rd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Brunswick",
            "state": "OH",
            "postal_code": "442122324",
            "country_code": "US",
            "telephone_number": "330-725-0569",
            "fax_number": "330-662-0258",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Weatherstone Dr Ste 106",
            "address_purpose": "LOCATION",
            "city": "Wadsworth",
            "state": "OH",
            "postal_code": "442817833",
            "country_code": "US",
            "telephone_number": "330-725-0569",
            "fax_number": "330-662-0258",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "128 E Milltown Rd Ste 208",
            "address_purpose": "LOCATION",
            "city": "Wooster",
            "state": "OH",
            "postal_code": "446911276",
            "country_code": "US",
            "telephone_number": "330-725-0569",
            "fax_number": "330-662-0258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERHOFF",
        "first_name": "MOLLY",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-15",
        "last_updated": "2020-10-31",
        "certification_date": "2020-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "180114",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.004868RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0386722",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rose Vasilakis
• Joselyn Vasquez, MSSA, LISW
• Holly Deanne Vavlas, LPC
• Roy Vellanki, MD
• Pushpalatha Tirumale Venkataraman, PHYSICIAN ASSISTANT
• Ann Marie Vetter, PA
• Daniel P Videc, LSW
• F Michelle Villeneuve, LPN
• Katelynn Vincent, PRS
• Megan Vitek, LPC, MFT

• Physician Assistant in Medina, OH
• Providers in Medina, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.

Verify at the official NPI Registry.