Individual provider Active NPI

Katelyn Polilli, APRN-CNP

  • Family Nurse Practitioner
  • Dover, OH
National Provider Identifier
1891328092
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
026228 Issued in OH
Practice address
400 Medical Park Dr Ste 101
Dover, OH 44622-3207
Phone
(330) 343-7581
NPI assigned
Feb 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 026228 OH Primary

Addresses

Primary practice location

400 Medical Park Dr Ste 101
Dover, OH 44622-3207

Mailing address

400 Medical Park Dr Ste 101
Dover, OH 44622-3207

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
I20200707002527 OH Practitioner - Nurse Practitioner 4789007923 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians
Union Physician Services LLCGroup PAC ID 0143366591, 97 clinicians

Practice addresses (Care Compare)

1 Akron General Ave
Akron, OH 44307-2432
Phone (330) 344-8990

659 Boulevard St
Dover, OH 44622-2026
Phone (330) 364-3311

Hospital & facility affiliations

  • Union Hospital Hospital, Dover, OH, CCN 360010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
026228OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Union Physician Services, LLC CurrentSince Jul 1, 2020 Accepting new patients
Partners Physician Group CurrentSince Nov 8, 2024 Accepting new patients
Partners Physician Group CurrentSince Nov 8, 2024 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Oct 31, 2025 Accepting new patients
Ohio Heart Care, Inc. PastSince Oct 1, 2020 Accepting new patients

Locations

1 Akron General Ave
Akron, OH 44307
Phone (330) 344-5760

224 W Exchange St
Ste 160
Akron, OH 44302
Phone (330) 344-6505

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

400 Medical Park Dr
Ste 101
Dover, OH 44622
Phone (330) 343-1335

205 Hospital Dr
Dover, OH 44622
Phone (330) 343-3335

821 Anola St
Dover, OH 44622
Phone (330) 343-2714

659 Boulevard St
Dover, OH 44622
Phone (330) 343-3311

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Organizations & group practices 5

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 1

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": "1581811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1891328092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MEDICAL PARK DR STE 101",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446223207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MEDICAL PARK DR STE 101",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446223207",
            "telephone_number": "330-343-7581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLILLI",
        "first_name": "KATELYN",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-16",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "026228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, OH

Sources for this page

Verify at the official NPI Registry.