Individual provider Active NPI

Melanie Mary Queener

  • Medical Physician Assistant
  • Wooster, OH
National Provider Identifier
1609513654
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
50.007740RX Issued in OH
Practice address
1740 Cleveland Rd
Wooster, OH 44691-2204
Phone
(330) 287-4500
NPI assigned
May 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 50.007740RX OH Primary

Addresses

Primary practice location

1740 Cleveland Rd
Wooster, OH 44691-2204

Mailing address

1740 Cleveland Rd
Wooster, OH 44691-2204
Phone (330) 287-4500

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
I20220927002108 OH Practitioner - Physician Assistant 7012393119 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians
Wooster Clinic LLCGroup PAC ID 6800708124, 290 clinicians

Practice addresses (Care Compare)

1 Park Centre Dr
Suite 304
Wadsworth, OH 44281-9482
Phone (330) 334-4620

1740 Cleveland Rd
Wooster, OH 44691-2204
Phone (330) 287-4500

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

970 E Washington St
Medina, OH 44256-2181

Hospital & facility affiliations

  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
  • Akron General Medical Center Hospital, Akron, OH, CCN 360027
  • Mercy Medical Center Hospital, Canton, OH, CCN 360070
  • Wooster Community Hospital Hospital, Wooster, OH, CCN 360036
  • Medina Hospital Hospital, Medina, OH, CCN 360091

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.007740RXOHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wooster Clinic, LLC CurrentSince Sep 14, 2022 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Sep 14, 2022 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Sep 14, 2022 Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

1740 Cleveland Rd
Wooster, OH 44691
Phone (330) 287-4500

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": "1652918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1609513654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 CLEVELAND RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912204",
            "telephone_number": "330-287-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 CLEVELAND RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912204",
            "telephone_number": "330-287-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEENER",
        "first_name": "MELANIE",
        "middle_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-19",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.007740RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

Verify at the official NPI Registry.