Individual provider Active NPI

Anthony Gibaldi, NP

  • Nurse Practitioner
  • Mentor, OH
National Provider Identifier
1871695783
Registry record updated May 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP07009 Issued in OH
Practice address
7350 Industrial Park Blvd
Mentor, OH 44060-5318
Phone
(216) 732-9480
Fax
(440) 942-8431
NPI assigned
Sep 1, 2006
Last updated
May 5, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP07009 OH Primary

Addresses

Primary practice location

7350 Industrial Park Blvd
Mentor, OH 44060-5318

Mailing address

PO Box 1239
Troy, MI 48099-1239
Phone (248) 824-6600

Other identifiers 1

IdentifierTypeStateIssuer
2444260MedicaidOH

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
I20040223000644 OH Practitioner - Nurse Practitioner 8224924808 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Medical Group Inc CurrentSince Apr 6, 2015 Accepting new patients
Alok Bhaiji, MD, Inc. PastSince Nov 8, 2019 Accepting new patients
Neurology and Neuroscience Associates, Inc. Past Accepting new patients
HCR Manorcare Medical Services of Florida LLC Nurse Practitioner Past Accepting new patients
Geriatric Nurse Practitioners, Inc. Nurse Practitioner Past Accepting new patients
Neurology and Neuroscience Associates Inc Past Accepting new patients

Locations

11100 Euclid Ave
Cleveland Heights, OH 44106

20800 Harvard Rd
Fl 2
Highland Hills, OH 44122
Phone (216) 358-2156

1335 Corporate Dr
#A
Hudson, OH 44236
Phone (330) 342-4020

6847 N Chestnut St
Ste 330
Ravenna, OH 44266
Phone (330) 296-8048

Organizations & group practices 6

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399248000000",
    "number": "1871695783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1239",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480991239",
            "telephone_number": "248-824-6600",
            "fax_number": "248-324-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7350 INDUSTRIAL PARK BLVD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440605318",
            "telephone_number": "216-732-9480",
            "fax_number": "440-942-8431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBALDI",
        "first_name": "ANTHONY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2014-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "NP07009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2444260",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

Verify at the official NPI Registry.