NPIMap

Individual provider Active NPI

Monique A Richardson, MD

  • Family Medicine Physician
  • Avon Lake, OH
National Provider Identifier
1619969110
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35072339 Issued in OH
Practice address
32730 Walker Rd
Building H
Avon Lake, OH 44012-4100
Phone
(440) 930-4955
Fax
(440) 930-4960
NPI assigned
Aug 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35072339 OH Primary

Addresses

Primary practice location

32730 Walker Rd
Building H
Avon Lake, OH 44012-4100

Mailing address

26908 Detroit Rd
Suite 301
Westlake, OH 44145-2398
Phone (440) 617-1823

Other identifiers 2

IdentifierTypeStateIssuer
080118001OtherOHRR MEDICARE
2051489MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address moniquerichardson@uhps.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050210000316 OH Practitioner - Family Practice 0749231439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical Branch at Galveston
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Primary Care Practices IncGroup PAC ID 3072417534, 1,071 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716

158 W Main Rd
Conneaut, OH 44030-2039

Hospital & facility affiliations

  • University Hospital Home Care Services, Inc Home health agency, Warrensville HTS, OH, CCN 367424
  • Uh St John Medical Center Hospital, Westlake, OH, CCN 360123
  • University Hospitals - Elyria Medical Center Hospital, Elyria, OH, CCN 360145
  • Uh Cleveland Medical Center Hospital, Cleveland, OH, CCN 360137

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35072339OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc Current Accepting new patients
University Primary Care Practices Inc Family Medicine CurrentSince Jan 1, 2017 Accepting new patients
University Primary Care Practices Inc CurrentSince Jan 1, 2017 Accepting new patients
University Hospitals Medical Group Inc Past Accepting new patients
University Primary Care Practices Past Accepting new patients

Locations

2535 Hale St
Ste B
Avon, OH 44011
Phone (440) 934-8858

2535 Hale St
Ste A
Avon, OH 44011
Phone (440) 617-1823

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

29325 Health Campus Dr
Ste 2
Westlake, OH 44145
Phone (440) 835-6142

26908 Detroit Rd
Ste 200
Westlake, OH 44145
Phone (440) 871-6060

Interoperability endpoints

  • Direct secure messaging: mrichardson37771@ehrdirect.uhhospitals.org

Organizations & group practices 5

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 7

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": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1619969110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26908 DETROIT RD",
            "address_2": "SUITE 301",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441452398",
            "telephone_number": "440-617-1823",
            "fax_number": "440-617-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32730 WALKER RD",
            "address_2": "BUILDING H",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440124100",
            "telephone_number": "440-930-4955",
            "fax_number": "440-930-4960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "MONIQUE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-19",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35072339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080118001",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2051489",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "moniquerichardson@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "32730 Walker Rd",
            "address_2": "Building H",
            "city": "Avon Lake",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440124100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Avon Lake, OH

Sources for this page

Verify at the official NPI Registry.