Individual provider Active NPI

Mikayla Paige Fauth, ACNPC-AG

  • Acute Care Nurse Practitioner
  • Avon, OH
National Provider Identifier
1821793233
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
436743 Issued in OH
Practice address
33300 Cleveland Clinic Blvd
Avon, OH 44011-1172
Phone
(440) 695-5000
NPI assigned
Apr 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 436743 OH Primary

Addresses

Primary practice location

33300 Cleveland Clinic Blvd
Avon, OH 44011-1172

Mailing address

649 Mayfield CT
Amherst, OH 44001-1331
Phone (440) 506-8025

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
I20230509001550 OH Practitioner - Nurse Practitioner 2961868351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-5433

Hospital & facility affiliations

  • Cleveland Clinic Avon Hospital Hospital, Avon, OH, CCN 360364
  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
436743OHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Apr 26, 2023 Accepting new patients

Locations

33300 Cleveland Clinic Blvd
Avon, OH 44011
Phone (440) 686-0105

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

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 and National Provider Directory roles.

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": "1680566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1821793233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "649 MAYFIELD CT",
            "city": "AMHERST",
            "state": "OH",
            "postal_code": "440011331",
            "telephone_number": "440-506-8025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33300 CLEVELAND CLINIC BLVD",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440111172",
            "telephone_number": "440-695-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUTH",
        "first_name": "MIKAYLA",
        "middle_name": "PAIGE",
        "name_prefix": "Mrs.",
        "credential": "ACNPC-AG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-04",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "436743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, OH

Sources for this page

Verify at the official NPI Registry.