NPIMap

Individual provider Active NPI

Myttle Mayuga, M.D.

  • Internal Medicine Physician
  • Ravenna, OH
National Provider Identifier
1780830950
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
57.014188 Issued in OH
Practice address
6847 N Chestnut St Ste 100
Ravenna, OH 44266-3929
Phone
(330) 297-6110
NPI assigned
Aug 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 57.014188 OH Primary

Addresses

Primary practice location

6847 N Chestnut St Ste 100
Ravenna, OH 44266-3929

Mailing address

6847 N Chestnut St Ste 100
Ravenna, OH 44266-3929
Phone (330) 297-6110

Other practice location 1

11100 Euclid Ave
Department of Medicine, Lakeside 3rd floor
Cleveland, OH 44106-1716
Phone (216) 844-3811

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address myttlemayuga@uhps.allscriptsdirect.net
Direct Messaging Address myttlemayuga@uhps.allscriptsdirect.net

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
I20170517002699 OH Practitioner - Cardiovascular Disease (Cardiology) 4688941966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Northwestern University Feinberg Medical School, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716

145 W Ave
Tallmadge, OH 44278-2250
Phone (330) 633-8341

158 W Main Rd
Conneaut, OH 44030-2039

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.15 of 100Reported as apm
Quality
82.31
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57.014188OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc CurrentSince May 1, 2017 Accepting new patients
University Primary Care Practices Inc Internal Medicine CurrentSince May 1, 2017 Accepting new patients
University Primary Care Practices Inc Current Accepting new patients
Multicare Health System Past Accepting new patients
University Hospitals Medical Group Inc Past Accepting new patients
University Primary Care Practices Past Accepting new patients

Locations

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

145 West Ave
Ste 3
Tallmadge, OH 44278

Interoperability endpoints

  • Direct secure messaging: mmayuga36870@ehrdirect.uhhospitals.org

Organizations & group practices 6

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": "1218067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1780830950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6847 N CHESTNUT ST STE 100",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663929",
            "telephone_number": "330-297-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6847 N CHESTNUT ST STE 100",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663929",
            "telephone_number": "330-297-6110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11100 Euclid Ave",
            "address_2": "Department of Medicine, Lakeside 3rd floor",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441061716",
            "country_code": "US",
            "telephone_number": "216-844-3811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYUGA",
        "first_name": "MYTTLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-07",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57.014188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "myttlemayuga@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "6847 N Chestnut St Ste 100",
            "city": "Ravenna",
            "state": "OH",
            "country_code": "US",
            "postal_code": "442663929",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "myttlemayuga@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "145 West Ave Ste 3",
            "city": "Tallmadge",
            "state": "OH",
            "country_code": "US",
            "postal_code": "442782250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ravenna, OH

Sources for this page

Verify at the official NPI Registry.