Individual provider Active NPI

Jennifer Madasz, APRN- CNP

  • Nurse Practitioner
  • Sylvania, OH
National Provider Identifier
1912247479
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP14294 Issued in OH
Practice address
8146 Timothy LN
Sylvania, OH 43560-1079
Phone
(567) 408-1496
Fax
(567) 600-5698
NPI assigned
Feb 21, 2013
Last updated
Nov 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP14294 OH Primary

Addresses

Primary practice location

8146 Timothy LN
Sylvania, OH 43560-1079

Mailing address

8146 Timothy LN
Sylvania, OH 43560-1079
Phone (567) 408-1496

Other identifiers 2

IdentifierTypeStateIssuer
0084478MedicaidOH
H198720OtherOHMEDICARE PIN

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
I20130615000181 OH Practitioner - Nurse Practitioner 3274772694 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP14294OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians Nurse Practitioner CurrentSince Jun 7, 2018 Accepting new patients
Promedica Central Physicians CurrentSince Jun 7, 2018 Accepting new patients
Everside Health, LLC PastSince Aug 1, 2020 Accepting new patients

Locations

650 Beaver Creek Cir
Ste 130
Maumee, OH 43537
Phone (419) 891-6210

5700 Monroe St
Sylvania, OH 43560
Phone (419) 473-6622

5700 Monroe St
Unit 111
Sylvania, OH 43560
Phone (567) 585-0005

1 Seagate
Ste 800
Toledo, OH 43604

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

Interoperability endpoints

  • Direct secure messaging: jmadaszaprncnp@gladstonemedical.kareodirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1912247479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8146 TIMOTHY LN",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435601079",
            "telephone_number": "567-408-1496",
            "fax_number": "567-600-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8146 TIMOTHY LN",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435601079",
            "telephone_number": "567-408-1496",
            "fax_number": "567-600-5698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADASZ",
        "first_name": "JENNIFER",
        "credential": "APRN- CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-21",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "NP14294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0084478",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "H198720",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.