Individual provider Active NPI

Heather L Holsenback, D.O.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Akron, OH
National Provider Identifier
1821022831
Registry record updated Mar 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
34-008374 Issued in OH
Practice address
1 Perkins SQ
Akron, OH 44308-1063
Phone
(330) 543-8452
Fax
(330) 543-3761
NPI assigned
Jul 10, 2006
Last updated
Mar 7, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 34008374 OH
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 34-008374 OH Primary

Addresses

Primary practice location

1 Perkins SQ
Akron, OH 44308-1063

Mailing address

1 Perkins SQ
Akron, OH 44308-1063
Phone (330) 543-8452

Other identifiers 1

IdentifierTypeStateIssuer
2576261MedicaidOH

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050712000826 OH Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 3678509551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Pediatric Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34008374OHMDPediatrics Physician
34-008374OHMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Medical Group Inc Pediatrics CurrentSince Nov 4, 2017 Accepting new patients

Locations

11100 Euclid Ave
Cleveland Heights, OH 44106

Interoperability endpoints

  • Direct secure messaging: hholsenback36747@ehrdirect.uhhospitals.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520380800000",
    "number": "1821022831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PERKINS SQ",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081063",
            "telephone_number": "330-543-8452",
            "fax_number": "330-543-3761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PERKINS SQ",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081063",
            "telephone_number": "330-543-8452",
            "fax_number": "330-543-3761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLSENBACK",
        "first_name": "HEATHER",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2018-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "34008374",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "OH",
            "license": "34-008374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2576261",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.