Individual provider Active NPI

Roxana Gramada, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Medina, OH
National Provider Identifier
1679360242
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0038091 Issued in OH
Practice address
3567 Reserve Commons Dr
Medina, OH 44256-5323
Phone
(330) 536-3746
NPI assigned
Apr 24, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0038091 OH Primary

Addresses

Primary practice location

3567 Reserve Commons Dr
Medina, OH 44256-5323

Mailing address

PO Box 40
Middlebranch, OH 44652-0040

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250729002317 OH Practitioner - Nurse Practitioner 6901313444

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

PO Box
Carol Stream, IL 60197

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1745452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1679360242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "MIDDLEBRANCH",
            "state": "OH",
            "postal_code": "446520040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3567 RESERVE COMMONS DR",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565323",
            "telephone_number": "330-536-3746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAMADA",
        "first_name": "ROXANA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-04-24",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0038091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

Verify at the official NPI Registry.