Individual provider Active NPI

Andrea Automilus Bester

  • Non-emergency Medical Transport (VAN)
  • Euclid, OH
National Provider Identifier
1871190959
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
RP931557 Issued in OH
Practice address
24390 Lake Shore Blvd Apt C
Euclid, OH 44123-1277
Phone
(216) 952-6615
NPI assigned
Oct 2, 2020
Reactivated
Mar 7, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X RP931557 OH Primary
Day Training/Habilitation SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 373H00000X RP931557 OH

Addresses

Primary practice location

24390 Lake Shore Blvd Apt C
Euclid, OH 44123-1277

Mailing address

24390 Lake Shore Blvd Apt C
Euclid, OH 44123-1277
Phone (216) 952-6615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RP931557OHMDDay Training/Habilitation Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Packij Solutions; LLC Single Specialty CurrentSince Oct 1, 2020 Accepting new patients

Locations

38257 Airport Pkwy
Unit 8
Willoughby, OH 44094

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.

NPI Registry JSON

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1871190959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24390 LAKE SHORE BLVD APT C",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441231277",
            "telephone_number": "216-952-6615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24390 LAKE SHORE BLVD APT C",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441231277",
            "telephone_number": "216-952-6615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BESTER",
        "first_name": "ANDREA",
        "middle_name": "AUTOMILUS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-02",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-08",
        "deactivation_date": "2020-10-20",
        "reactivation_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "OH",
            "license": "RP931557",
            "primary": true
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Day Training/Habilitation Specialist",
            "state": "OH",
            "license": "RP931557",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Euclid, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.