Nicole E Petgrave, NURSE PRACTITIONER

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

APRN.CNP.024887 Issued in OH

Practice address

8200 Mentor Hills Dr
Mentor, OH 44060-7861

Phone

(800) 427-1902

Fax

(419) 531-2664

NPI assigned

Oct 14, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mills Medical Practices LLCGroup PAC ID 4981767597, 24 clinicians

Abode Care Partners Al VB LLCGroup PAC ID 1658403704, 48 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

66.34 of 100Reported as group

Quality

63.79

Promoting interoperability

0

Improvement activities

40

Cost

74.03

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Abode Care Partners Al VB, LLC

  • Nurse Practitioner
  • Mason, OH
  • NPI 1104695550
  Medicare reassignment Care Compare group
• Mills Medical Practices, LLC

  • Primary Care Clinic/Center
  • Beachwood, OH
  • NPI 1477701969
  Medicare reassignment Care Compare group
• Caremed Ohio LLC

  • Multi-Specialty Clinic/Center
  • Kenton, OH
  • NPI 1669123949
  Medicare reassignment NPD
• Ohio Living Palliative Care Greater Toledo LLC

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1861981656
  Medicare reassignment NPD
• Premium Quality NP, LLC

  • Primary Care Nurse Practitioner
  • Medina, OH
  • NPI 1891303764
  Medicare reassignment NPD
• Traveling Nurse Practitioner, LLC

  • General Practice Registered Nurse
  • Wadsworth, OH
  • NPI 1588995849
  Medicare reassignment NPD
• Abode Care Partners LTC VB, LLC

  • Nurse Practitioner
  • Mason, OH
  • NPI 1144099318
  Medicare reassignment
• HCR Manorcare Medical Services of Florida LLC

  dba Heartland Care Partners

  • Nurse Practitioner
  • Toledo, OH
  • NPI 1386750420
  NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375
  NPD

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

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1649812405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST FL 7",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041531",
            "telephone_number": "419-252-6018",
            "fax_number": "800-564-5952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 MENTOR HILLS DR",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440607861",
            "telephone_number": "800-427-1902",
            "fax_number": "419-531-2664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETGRAVE",
        "first_name": "NICOLE",
        "middle_name": "E",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-14",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "APRN.CNP.024887",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "APRN.CNP.024887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Pestak
• Lea Petche, RN
• Stephanie Veronica Peter, PT, DPT
• Matthew Peterson, NP
• Michael C Peterson, PA-C
• Kim Petro
• Katherine J Petrochic, LPCC
• Natasha L. Petrow, RN
• Jeannine Marie Petti, LSW, LCDCIII
• Jocelyn Rose Pettitt, O.D.

• Gerontology Nurse Practitioner in Mentor, OH
• Providers in Mentor, OH by specialty
• Gerontology Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.