Individual provider Active NPI

Nicole Jade Kobak-Birk, PA-C

  • Physician Assistant
  • Berea, OH
National Provider Identifier
1609460906
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.007025RX Issued in OH
Practice address
275 Eastland Rd
Berea, OH 44017-2005
Phone
(440) 826-2221
NPI assigned
Feb 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.007025RX OH Primary

Addresses

Primary practice location

275 Eastland Rd
Berea, OH 44017-2005

Mailing address

6847 N Chestnut St
Ravenna, OH 44266-3929

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
I20210716002575 OH Practitioner - Physician Assistant 9436551181 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians
Lutheran HospitalGroup PAC ID 2466358387, shared by 3 NPIs, 24 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716

1730 W 25TH St
Cleveland, OH 44113-3108
Phone (440) 826-1822

Hospital & facility affiliations

  • University Hospitals Portage Medical Center Hospital, Ravenna, OH, CCN 360078
  • Lutheran Hospital Hospital, Cleveland, OH, CCN 360087
  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180

Merit-based Incentive Payment System (MIPS)

Final score
81.19 of 100Reported as group
Quality
63.13
Promoting interoperability
100
Improvement activities
40
Cost
74.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.007025RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Medical Group Inc CurrentSince Oct 1, 2022 Accepting new patients
Baldwin Wallace University PastSince Mar 4, 2021 Accepting new patients

Locations

11100 Euclid Ave
Cleveland Heights, OH 44106

6847 N Chestnut St
Ravenna, OH 44266
Phone (330) 296-9606

Interoperability endpoints

  • Direct secure messaging: nkobakbirk28396@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 3

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": "1614297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1609460906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6847 N CHESTNUT ST",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 EASTLAND RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440172005",
            "telephone_number": "440-826-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBAK-BIRK",
        "first_name": "NICOLE",
        "middle_name": "JADE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-26",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.007025RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berea, OH

Sources for this page

Verify at the official NPI Registry.