Individual provider Active NPI

Mackenzie Varkula, D.O.

  • Child & Adolescent Psychiatry Physician
  • Cleveland, OH
National Provider Identifier
1891973608
Registry record updated Jun 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
34.009623 Issued in OH
Practice address
18101 Lorain Ave
Ppsy
Cleveland, OH 44111-5612
Phone
(216) 476-6958
Fax
(216) 476-4845
NPI assigned
Feb 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 34.009623 OH Primary

Addresses

Primary practice location

18101 Lorain Ave
Ppsy
Cleveland, OH 44111-5612

Mailing address

18101 Lorain Ave
Ppsy
Cleveland, OH 44111-5612
Phone (216) 476-6958

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100512000055 OH Practitioner - Psychiatry 6204964331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Lake Erie College of Osteopathic Medicine, Erie, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Coast Mental Health Associates IncGroup PAC ID 5597661439, 10 clinicians

Practice addresses (Care Compare)

3690 Orange PL
Beachwood, OH 44122-4467
Phone (216) 464-5330

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Coast Mental Health Associates Inc. CurrentSince Jun 20, 2019 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients

Locations

3690 Orange Pl
Ste 430
Beachwood, OH 44122
Phone (216) 464-5330

Interoperability endpoints

  • Direct secure messaging: mvarkula61849@direct.ccf.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276128000000",
    "number": "1891973608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18101 LORAIN AVE",
            "address_2": "PPSY",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441115612",
            "telephone_number": "216-476-6958",
            "fax_number": "216-476-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 LORAIN AVE",
            "address_2": "PPSY",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441115612",
            "telephone_number": "216-476-6958",
            "fax_number": "216-476-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARKULA",
        "first_name": "MACKENZIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-04",
        "last_updated": "2010-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OH",
            "license": "34.009623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.