Individual provider Active NPI

Judy Yakunich, M.A.,C.C.C.-A

  • Audiologist
  • Cleveland, OH
National Provider Identifier
1851556047
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A-01153 Issued in OH
Practice address
15299 Bagley Rd
#300
Cleveland, OH 44130-4823
Phone
(440) 779-1112
NPI assigned
Jul 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A-01153 OH Primary

Addresses

Primary practice location

15299 Bagley Rd
#300
Cleveland, OH 44130-4823

Mailing address

15299 Bagley Rd Ste 300
Cleveland, OH 44130-4809
Phone (440) 816-5091

Other identifiers 4

IdentifierTypeStateIssuer
0972309MedicaidOH
2085550MedicaidOH
2085523MedicaidOH
P00681449OtherOHMEDICARE RAILROAD PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jyakunich@direct.swgeneral.com Southwest General Medical Group Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081023000308 OH Practitioner - Qualified Audiologist 7113085929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest General Medical Group IncGroup PAC ID 8527964550, 232 clinicians

Practice addresses (Care Compare)

15299 Bagley Rd
Suite 300
Cleveland, OH 44130-4823
Phone (440) 816-5091

Merit-based Incentive Payment System (MIPS)

Final score
81.06 of 100Reported as group
Quality
63.56
Promoting interoperability
100
Improvement activities
40
Cost
73.3

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
A-01153OHMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest General Medical Group, Inc. CurrentSince Feb 1, 2018 Accepting new patients
Southwest General Medical Group Inc CurrentSince Feb 1, 2018 Accepting new patients
Southwest General Medical Group Inc Audiologist Current Accepting new patients

Locations

7255 Old Oak Blvd
Ste C202
Middleburg Heights, OH 44130
Phone (440) 816-5390

15299 Bagley Rd
Ste 300
Middleburg Heights, OH 44130
Phone (440) 234-5150

25761 Lorain Rd
Fl 3
North Olmsted, OH 44070
Phone (440) 779-1112

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1851556047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15299 BAGLEY RD STE 300",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441304809",
            "telephone_number": "440-816-5091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15299 BAGLEY RD",
            "address_2": "#300",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441304823",
            "telephone_number": "440-779-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAKUNICH",
        "first_name": "JUDY",
        "credential": "M.A.,C.C.C.-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A-01153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0972309",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2085550",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2085523",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PTAN",
            "identifier": "P00681449",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jyakunich@direct.swgeneral.com",
            "affiliation": "Y",
            "affiliationName": "Southwest General Medical Group Inc",
            "address_1": "15299 Bagley Rd",
            "address_2": "#300",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441304823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.