Individual provider Active NPI

Theresa Gersin, FNP-C

  • Family Nurse Practitioner
  • Painesville, OH
National Provider Identifier
1730843541
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0030097 Issued in OH
Practice address
74 S Park PL
Painesville, OH 44077-3417
Phone
(330) 468-3312
NPI assigned
Oct 27, 2021
Last updated
Oct 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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 0030097 OH Primary

Addresses

Primary practice location

74 S Park PL
Painesville, OH 44077-3417

Mailing address

7632 Crimson CT
Mentor, OH 44060-7078

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
I20211201002862 OH Practitioner - Nurse Practitioner 7618367897 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-8447

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0030097OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Cleveland Medical Center CurrentSince May 9, 2022 Accepting new patients
Fairview Hospital CurrentSince Nov 23, 2022 Accepting new patients
Fairview Hospital Current Accepting new patients
University Hospitals Cleveland Medical Center CurrentSince May 9, 2022 Accepting new patients

Locations

10654 Lorain Ave
Cleveland, OH 44111
Phone (216) 941-1044

18101 Lorain Ave
Cleveland, OH 44111
Phone (216) 476-7029

11100 Euclid Ave
Cleveland Heights, OH 44106

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Interoperability endpoints

  • Direct secure messaging: tgersin41410@ehrdirect.uhhospitals.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1730843541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7632 CRIMSON CT",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440607078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 S PARK PL",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440773417",
            "telephone_number": "330-468-3312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERSIN",
        "first_name": "THERESA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-10-27",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0030097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Painesville, OH

Sources for this page

Verify at the official NPI Registry.