NPIMap

Individual provider Active NPI

Jared Christopher Storck, D.O.

  • Plastic and Reconstructive Surgery Physician
  • Woodmere, OH
National Provider Identifier
1760686398
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
34-009221 Issued in OH
Practice address
28601 Chagrin Blvd Ste 500
Woodmere, OH 44122-4562
Phone
(216) 561-0312
Fax
(216) 561-0113
NPI assigned
Jun 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 34-009221 OH
Plastic and Reconstructive Surgery Physician 2086S0122X 34-009221 OH Primary

Addresses

Primary practice location

28601 Chagrin Blvd Ste 500
Woodmere, OH 44122-4562

Mailing address

28601 Chagrin Blvd Ste 500
Woodmere, OH 44122-4562
Phone (216) 561-0312

Other identifiers 1

IdentifierTypeStateIssuer
0052994MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120130000339 OH Practitioner - General Surgery 0648437996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Lake Erie College of Osteopathic Medicine, Erie, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Plastic Surgery Institute of Ohio LLC 3 clinicians

Practice addresses (Care Compare)

28601 Chagrin Blvd
Suite 500
Woodmere, OH 44122-4562
Phone (216) 561-0312

Hospital & facility affiliations

  • South Pointe Hospital Hospital, Warrensville Heights, OH, CCN 360144
  • University Hospitals Portage Medical Center Hospital, Ravenna, OH, CCN 360078
  • Hillcrest Hospital Hospital, Mayfield Heights, OH, CCN 360230
  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
  • University Hospitals Ahuja Medical Center Hospital, Beachwood, OH, CCN 360359

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy17
Melanoma (skin cancer) excision1-10
Removal of tissue393
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34-009221OHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Plastic Surgery Institute of Ohio, LLC Surgery CurrentSince Sep 3, 2013 Accepting new patients
North East Ohio Health Services Past Accepting new patients
Roger F. Classen, D.O., Inc. Surgery Past Accepting new patients

Locations

9318 State Route 14
Streetsboro, OH 44241
Phone (330) 626-4080

9318 State Route 14
Ste E
Streetsboro, OH 44241

4100 Warrensville Center Rd
Ste 101
Warrensville Heights, OH 44122
Phone (216) 561-0111

28601 Chagrin Blvd
Ste 500
Woodmere, OH 44122
Phone (216) 561-0312

Interoperability endpoints

  • Direct secure messaging: jstorck36041@ehrdirect.uhhospitals.org

Organizations & group practices 3

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 5

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": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1760686398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28601 CHAGRIN BLVD STE 500",
            "city": "WOODMERE",
            "state": "OH",
            "postal_code": "441224562",
            "telephone_number": "216-561-0312",
            "fax_number": "216-561-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28601 CHAGRIN BLVD STE 500",
            "city": "WOODMERE",
            "state": "OH",
            "postal_code": "441224562",
            "telephone_number": "216-561-0312",
            "fax_number": "216-561-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORCK",
        "first_name": "JARED",
        "middle_name": "CHRISTOPHER",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "34-009221",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "OH",
            "license": "34-009221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0052994",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodmere, OH

Sources for this page

Verify at the official NPI Registry.