NPIMap

Organization Active NPI

New Pathways Clinic LLC

  • Psychiatry Physician
  • Middleburg Heights, OH
National Provider Identifier
1619640414
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
NEW PATHWAYS CLINIC LLC
Practice address
18660 Bagley Rd Ste 101
Middleburg Heights, OH 44130-3483
Phone
(440) 973-8400
Fax
(440) 201-6400
NPI assigned
Jul 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Authorized official

Name
Stephen Suntala
Title
Owner
Phone
(440) 973-8400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

18660 Bagley Rd Ste 101
Middleburg Heights, OH 44130-3483

Mailing address

18660 Bagley Rd Ste 101
Middleburg Heights, OH 44130-3483
Phone (440) 973-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210809002387 OH Part B Supplier - Clinic/Group Practice 9436553716 Receives reassigned benefits from 13 practitioners
Practice locations: Willoughby, OH; Montgomery, OH; Middleburg Heights, OH; Dublin, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2294621New Pathways Clinic18660 Bagley Rd, Ste 101, Middleburg Heights, OH 44130Certificate of waiverNov 27, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627430400000",
    "number": "1619640414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18660 BAGLEY RD STE 101",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303483",
            "telephone_number": "440-973-8400",
            "fax_number": "440-201-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18660 BAGLEY RD STE 101",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303483",
            "telephone_number": "440-973-8400",
            "fax_number": "440-201-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW PATHWAYS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A",
        "authorized_official_last_name": "SUNTALA",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-973-8400"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleburg Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.