Active NPI
Micah Ashley Pistillo
- Physician Assistant
- Akron, OH
National Provider Identifier
1891408555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 50.008839RX
- Practice address
- 214 W Bowery St
Akron, OH 44308-1046 - Phone
- (330) 543-1000
- NPI assigned
- Dec 27, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 50.008839RX | OH | Primary |
Addresses
Primary practice location
214 W Bowery St
Akron, OH 44308-1046
Mailing address
275 Eastland Rd
Berea, OH 44017-2005
Phone (440) 826-2900
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
| License | State | Type | Specialty |
|---|---|---|---|
| 50.008839RX | OH | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baldwin Wallace University | Past | Accepting new patients |
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.
-
- Student Health Clinic/Center
- Berea, OH
- NPI 1730157272
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720569600000",
"number": "1891408555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 EASTLAND RD",
"city": "BEREA",
"state": "OH",
"postal_code": "440172005",
"telephone_number": "440-826-2900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "214 W BOWERY ST",
"city": "AKRON",
"state": "OH",
"postal_code": "443081046",
"telephone_number": "330-543-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PISTILLO",
"first_name": "MICAH",
"middle_name": "ASHLEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-27",
"last_updated": "2024-07-10",
"certification_date": "2024-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50.008839RX",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Akron, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.