Individual provider Active NPI

Jelena P Stevanovic, PH.D.

  • Clinical Psychologist
  • Akron, OH
National Provider Identifier
1871735498
Registry record updated Apr 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6441 Issued in OH
Practice address
75 Arch St
Suite 104
Akron, OH 44304-1429
Phone
(330) 375-4851
Fax
(330) 375-4228
NPI assigned
Mar 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6441 OH Primary

Addresses

Primary practice location

75 Arch St
Suite 104
Akron, OH 44304-1429

Mailing address

525 E Market St
PO Box 2090
Akron, OH 44304-1619
Phone (330) 996-8603

Other identifiers 1

IdentifierTypeStateIssuer
2976954MedicaidOH

Other names 1

  • Jelena Pavlovic Former name

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090617000691 OH Practitioner - Clinical Psychologist 6002966728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summa Physicians LLCGroup PAC ID 2961303532, 692 clinicians

Practice addresses (Care Compare)

525 E Market St
Akron, OH 44304-1619

75 Arch St
Suite 301
Akron, OH 44304-1429
Phone (330) 253-1800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6441OHMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Summa Physicians LLC Clinical CurrentSince May 1, 2009 Accepting new patients
Summa Physicians LLC CurrentSince May 1, 2009 Accepting new patients
Summa Physicians LLC Current Accepting new patients

Locations

525 E Market St
Akron, OH 44304
Phone (330) 375-6350

1077 Gorge Blvd
Akron, OH 44310
Phone (234) 312-5691

75 Arch St
Ste 104
Akron, OH 44304
Phone (330) 375-4851

444 N Main St
Ste 408
Akron, OH 44310
Phone (330) 379-8121

Interoperability endpoints

  • Direct secure messaging: jstevanovic30440@summahealth-direct.org

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.

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": "1238112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301616000000",
    "number": "1871735498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E MARKET ST",
            "address_2": "PO BOX 2090",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443041619",
            "telephone_number": "330-996-8603",
            "fax_number": "330-996-8695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 ARCH ST",
            "address_2": "SUITE 104",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443041429",
            "telephone_number": "330-375-4851",
            "fax_number": "330-375-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVANOVIC",
        "first_name": "JELENA",
        "middle_name": "P",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-27",
        "last_updated": "2011-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "6441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2976954",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JELENA",
            "last_name": "PAVLOVIC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.