Individual provider Active NPI

Tony L Denicola, CRNP

  • Adult Health Nurse Practitioner
  • Parma, OH
National Provider Identifier
1740681196
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
16442 Issued in OH
Practice address
12380 Plaza Dr
Suite 101
Parma, OH 44130-1043
Phone
(216) 898-8488
Fax
(216) 362-0677
NPI assigned
Sep 4, 2014
Last updated
Sep 4, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 16442 OH Primary

Addresses

Primary practice location

12380 Plaza Dr
Suite 101
Parma, OH 44130-1043

Mailing address

12380 Plaza Dr
Suite 101
Parma, OH 44130-1043
Phone (216) 898-8488

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
I20141008002016 OH Practitioner - Nurse Practitioner 9133349491 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

29101 Health Campus Dr
Suite 250
Westlake, OH 44145-5277
Phone (440) 827-5483

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16442OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc CurrentSince Jan 8, 2026 Accepting new patients
University Hospitals Medical Group Inc CurrentSince Jan 8, 2026 Accepting new patients
University Primary Care Practices Inc CurrentSince Jan 8, 2026 Accepting new patients

Locations

11100 Euclid Ave
Cleveland Heights, OH 44106

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

630 E River St
Elyria, OH 44035
Phone (440) 329-7450

29101 Health Campus Dr
Ste 250
Westlake, OH 44145
Phone (440) 827-5483

Organizations & group practices 4

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.

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": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1740681196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12380 PLAZA DR",
            "address_2": "SUITE 101",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441301043",
            "telephone_number": "216-898-8488",
            "fax_number": "216-362-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12380 PLAZA DR",
            "address_2": "SUITE 101",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441301043",
            "telephone_number": "216-898-8488",
            "fax_number": "216-362-0677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENICOLA",
        "first_name": "TONY",
        "middle_name": "L",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-04",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "16442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parma, OH

Sources for this page

Verify at the official NPI Registry.