Individual provider Active NPI

Mark Nellenbach, PA-C

  • Physician Assistant
  • Cleveland, OH
National Provider Identifier
1699258244
Registry record updated Sep 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
11100 Euclid Ave
Cleveland, OH 44106-1716
Phone
(216) 844-4951
NPI assigned
Sep 10, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OH Primary

Addresses

Primary practice location

11100 Euclid Ave
Cleveland, OH 44106-1716

Mailing address

2175 Kerwin Rd Apt 503
University Heights, OH 44118-3979
Phone (315) 404-3055

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
I20181130000333 OH Practitioner - Physician Assistant 3577807684 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

1000 E Washington St
Medina, OH 44256-2167
Phone (216) 442-1270

Hospital & facility affiliations

  • Hillcrest Hospital Hospital, Mayfield Heights, OH, CCN 360230
  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180

Merit-based Incentive Payment System (MIPS)

Final score
81.19 of 100Reported as group
Quality
63.13
Promoting interoperability
100
Improvement activities
40
Cost
74.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Jan 21, 2026 Accepting new patients
University Hospitals Cleveland Medical Center Physician Assistant CurrentSince Nov 1, 2018 Accepting new patients
Hometown Urgent Care of Michigan, P.C. CurrentSince Dec 20, 2021 Accepting new patients
University Hospitals Urgent Care, LLC CurrentSince Jul 17, 2023 Accepting new patients
University Hospitals Cleveland Medical Center CurrentSince Nov 1, 2018 Accepting new patients
Hometown Urgent Care of Michigan, PC CurrentSince Dec 20, 2021 Accepting new patients
University Hospitals Medical Group Inc CurrentSince Mar 15, 2020 Accepting new patients

Locations

3909 Orange Pl
Ste 2100
Beachwood, OH 44122
Phone (216) 896-1800

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

11100 Euclid Ave
Cleveland Heights, OH 44106

6210 Brandt Pike
Huber Heights, OH 45424
Phone (937) 236-8630

1000 E Washington St
Medina, OH 44256
Phone (330) 654-1185

Interoperability endpoints

  • Direct secure messaging: mnellenbach39739@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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1699258244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2175 KERWIN RD APT 503",
            "city": "UNIVERSITY HEIGHTS",
            "state": "OH",
            "postal_code": "441183979",
            "telephone_number": "315-404-3055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061716",
            "telephone_number": "216-844-4951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELLENBACH",
        "first_name": "MARK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-10",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.