NPIMap

Individual provider Active NPI

Diana Lee Mackensen, FNP-C

  • Family Nurse Practitioner
  • Willoughby, OH
National Provider Identifier
1629575329
Registry record updated Apr 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.021979 Issued in OH
Practice address
36060 Euclid Ave
Willoughby, OH 44094-4656
Phone
(440) 953-9600
NPI assigned
Apr 9, 2018
Last updated
Apr 9, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.021979 OH Primary

Addresses

Primary practice location

36060 Euclid Ave
Willoughby, OH 44094-4656

Mailing address

5699 Charmar Dr
Mentor, OH 44060-1902
Phone (440) 749-9456

Other practice location 1

7590 Auburn Rd
Painesville, OH 44077-9176
Phone (440) 375-8100

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
I20180709000593 OH Practitioner - Nurse Practitioner 0446506356 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Axelix Health Consulting IncGroup PAC ID 9032243779, 4 clinicians

Practice addresses (Care Compare)

7590 Auburn Rd
Painesville, OH 44077-9176
Phone (440) 375-8100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.07 of 100Reported as group
Quality
92.55
Improvement activities
40
Cost
79.49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Axelix Health Consulting, Inc CurrentSince Feb 1, 2022 Accepting new patients
Lake Hospital System, Inc CurrentSince Jun 1, 2018 Accepting new patients
Lake Hospital System Inc CurrentSince Jun 1, 2018 Accepting new patients
Lake Hospital System Inc Current Accepting new patients
Lake Hospital System, Inc Past Accepting new patients
Lake Hospital System Inc Past Accepting new patients
Michael P Binder MD LTD Past Accepting new patients

Locations

7590 Auburn Rd
Concord Township, OH 44077
Phone (440) 354-1899

8587 East Ave
Mentor, OH 44060
Phone (440) 867-4800

10780 Kinsman Rd
Newbury, OH 44065
Phone (440) 564-5656

38033 Euclid Ave
Ste T8
Willoughby, OH 44094
Phone (440) 867-4800

Interoperability endpoints

  • Direct secure messaging: dmackensen28270@ehrdirect.uhhospitals.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1629575329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5699 CHARMAR DR",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440601902",
            "telephone_number": "440-749-9456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36060 EUCLID AVE",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440944656",
            "telephone_number": "440-953-9600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7590 Auburn Rd",
            "address_purpose": "LOCATION",
            "city": "Painesville",
            "state": "OH",
            "postal_code": "440779176",
            "country_code": "US",
            "telephone_number": "440-375-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKENSEN",
        "first_name": "DIANA",
        "middle_name": "LEE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.021979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

Verify at the official NPI Registry.