Michael Mastrangelo

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

50004167 Issued in OH

Practice address

1120 E Broad St
Elyria, OH 44035-6306

Phone

(440) 365-2600

Fax

(440) 366-5543

NPI assigned

Nov 20, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Medicare reassignment NPD
• The Cleveland Clinic Foundation

  • Family Medicine Physician
  • Avon, OH
  • NPI 1184428336
  NPD
• Mercy Health-Allen Hospital LLC

  • Rural Health Clinic/Center
  • Wellington, OH
  • NPI 1780818963
  NPD (past)

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

{
    "created_epoch": "1416441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422921600000",
    "number": "1881091882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636643",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636643",
            "telephone_number": "440-989-3801",
            "fax_number": "440-960-0264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 E BROAD ST",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356306",
            "telephone_number": "440-365-2600",
            "fax_number": "440-366-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTRANGELO",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-20",
        "last_updated": "2015-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50004167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3025372",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laurel Marshall, DMD, MS
• Colleen F Martin-Telfer, LSW
• Alisa Marvin, PA-C
• Mary Elaine Krosse, DPM
• Ramiz Masri, M.D.
• Shelle Mathis, L.P.C.C.
• Matthias Helfrich O.D. Inc
• Michelle Marie Mattingly
• James Maxwell, LSW
• Kathleen Mayer

• Medical Physician Assistant in Elyria, OH
• Providers in Elyria, OH by specialty
• Medical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.