Individual provider Active NPI

Jennifer Rose Sopko, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Painesville, OH
National Provider Identifier
1730866898
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0034276 Issued in OH
Practice address
1018 Valewood CT
Painesville, OH 44077-1153
Phone
(440) 725-6555
NPI assigned
Jun 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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.0034276 OH Primary

Addresses

Primary practice location

1018 Valewood CT
Painesville, OH 44077-1153

Mailing address

1018 Valewood CT
Painesville, OH 44077-1153
Phone (440) 725-6555

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
I20230803004215 OH Practitioner - Nurse Practitioner 6002277290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alcove Ventures LLCGroup PAC ID 1456669605, 50 clinicians

Practice addresses (Care Compare)

3567 Reserve Commons Dr
Suite 100
Medina, OH 44256-5344
Phone (330) 536-3746

Merit-based Incentive Payment System (MIPS)

Final score
98.06 of 100Reported as group
Quality
90.22
Promoting interoperability
100
Improvement activities
40
Cost
69.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0034276OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alcove Ventures LLC Psychiatric/Mental Health CurrentSince Jul 21, 2023 Accepting new patients

Locations

3593 Medina Rd
Medina, OH 44256
Phone (330) 664-9250

3567 Reserve Commons Dr
Ste 100
Medina, OH 44256
Phone (330) 664-9250

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1688083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1730866898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 VALEWOOD CT",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440771153",
            "telephone_number": "440-725-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 VALEWOOD CT",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440771153",
            "telephone_number": "440-725-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOPKO",
        "first_name": "JENNIFER",
        "middle_name": "ROSE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-30",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0034276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Painesville, OH

Sources for this page

Verify at the official NPI Registry.