Organization Active NPI

Veranova Health

  • Obstetrics & Gynecology Physician
  • Middleburg Heights, OH
National Provider Identifier
1639897846
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
VERANOVA HEALTH
Practice address
7379 Pearl Rd
Middleburg Heights, OH 44130-4898
Phone
(440) 732-2173
Fax
(216) 502-4186
NPI assigned
Aug 15, 2022
Last updated
Aug 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Authorized official

Name
Tim Jakubisin
Title
Founder
Phone
(440) 527-1070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X Primary

Addresses

Primary practice location

7379 Pearl Rd
Middleburg Heights, OH 44130-4898

Mailing address

21881 Marian Cir
Fairview Park, OH 44126-2617
Phone (440) 527-1070

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230111001095 OH Part B Supplier - Clinic/Group Practice 7315317211 Receives reassigned benefits from 10 practitioners
Practice locations: Middleburg Heights, 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
36D2269988Veranova Health7379 Pearl Road, Middleburg Heights, OH 44130Certificate of waiverOct 5, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1639897846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21881 MARIAN CIR",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441262617",
            "telephone_number": "440-527-1070",
            "fax_number": "216-502-4186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7379 PEARL RD",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441304898",
            "telephone_number": "440-732-2173",
            "fax_number": "216-502-4186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERANOVA HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A",
        "authorized_official_last_name": "JAKUBISIN",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "440-527-1070"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "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 Aug 15, 2022; 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.