Individual provider Active NPI

Robert W Mitri, PA-C

  • Physician Assistant
  • Mayfield HTS, OH
National Provider Identifier
1780853903
Registry record updated Feb 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50-002716 Issued in OH
Practice address
6780 Mayfield Rd
Mayfield HTS, OH 44124-2203
Phone
(440) 449-4500
NPI assigned
Feb 21, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50-002716 OH Primary

Addresses

Primary practice location

6780 Mayfield Rd
Mayfield HTS, OH 44124-2203

Mailing address

PO Box 74647
Cleveland, OH 44194-0001
Phone (440) 879-0081

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
I20080305000738 OH Practitioner - Physician Assistant 0244315992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6780 Mayfield Rd
Mayfield Heights, OH 44124-2203
Phone (440) 449-4500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50-002716OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cleveland Clinic Health System - East Region CurrentSince Dec 12, 2007 Accepting new patients
Cleveland Clinic Health System - East Region CurrentSince Dec 12, 2007 Accepting new patients

Locations

18901 Lake Shore Blvd
Euclid, OH 44119
Phone (216) 531-9000

6780 Mayfield Rd
Mayfield Hts, OH 44124
Phone (440) 331-9520

Organizations & group practices 2

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 1

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": "1203552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203552000000",
    "number": "1780853903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74647",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441940001",
            "telephone_number": "440-879-0081",
            "fax_number": "440-879-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6780 MAYFIELD RD",
            "city": "MAYFIELD HTS",
            "state": "OH",
            "postal_code": "441242203",
            "telephone_number": "440-449-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITRI",
        "first_name": "ROBERT",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-21",
        "last_updated": "2008-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50-002716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield HTS, OH

Sources for this page

Verify at the official NPI Registry.