Individual provider Active NPI

Lawrence M Kovalcik, PA-C

  • Physician Assistant
  • Lorain, OH
National Provider Identifier
1851338487
Registry record updated Dec 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50000818 Issued in OH
Practice address
3700 Kolbe Rd
Lorain, OH 44053-1611
Phone
(440) 960-3000
NPI assigned
Jun 1, 2006
Last updated
Dec 30, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2007

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 50000818 OH Primary

Addresses

Primary practice location

3700 Kolbe Rd
Lorain, OH 44053-1611

Mailing address

51820 Betts Rd
Wellington, OH 44090-9728

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
I20060627000000 OH Practitioner - Physician Assistant 6507878055 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Lorain Specialty Care LLCGroup PAC ID 4688070055, 134 clinicians
Mercy Health-Allen Hospital LLCGroup PAC ID 5092802389, 14 clinicians

Practice addresses (Care Compare)

224 W Lorain St
Suite 100
Oberlin, OH 44074-1087
Phone (440) 222-4140

578 N Leavitt Rd
Amherst, OH 44001-1131
Phone (440) 960-3912

5940 Oak Point Rd
Lorain, OH 44053-4100
Phone (440) 988-3705

840 Patriot Dr
Wellington, OH 44090-8948
Phone (440) 647-2225

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50000818OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Lorain Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians, Lorain, LLC CurrentSince Mar 16, 2020 Accepting new patients
Mercy Health-Allen Hospital LLC CurrentSince Mar 16, 2020 Accepting new patients
Emergency Professionals of Ohio, Inc. Physician Assistant Past Accepting new patients

Locations

578 N Leavitt Rd
Amherst, OH 44001
Phone (440) 960-3912

3700 Kolbe Rd
Lorain, OH 44053
Phone (440) 331-9520

840 Patriot Dr
Wellington, OH 44090
Phone (440) 647-2225

29000 Center Ridge Rd
Westlake, OH 44145
Phone (440) 414-6046

Interoperability endpoints

  • Direct secure messaging: lkovalcik52980@direct.bsmhealth.org

Organizations & group practices 7

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 3

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198972800000",
    "number": "1851338487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51820 BETTS RD",
            "city": "WELLINGTON",
            "state": "OH",
            "postal_code": "440909728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 KOLBE RD",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440531611",
            "telephone_number": "440-960-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVALCIK",
        "first_name": "LAWRENCE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2007-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50000818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorain, OH

Sources for this page

Verify at the official NPI Registry.