Individual provider Active NPI

Lyndsey Rachelle Decesare

  • Nurse Practitioner
  • Mayfield Village, OH
National Provider Identifier
1912540543
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.025741 Issued in OH
Practice address
6559 Wilson Mills Rd Ste 106a
Mayfield Village, OH 44143-3433
Phone
(855) 449-1540
Fax
(440) 672-5068
NPI assigned
Oct 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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 APRN.CNP.025741 OH Primary

Addresses

Primary practice location

6559 Wilson Mills Rd Ste 106a
Mayfield Village, OH 44143-3433

Mailing address

PO Box 952041
Cleveland, OH 44192-0051
Phone (855) 449-1540

Other names 1

  • Lyndsey Rachelle Kytta Former name

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
I20220125001361 OH Practitioner - Nurse Practitioner 9537551502 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
Telehealth
Offers telehealth services
Group practices
Mukunda Medical Group LLCGroup PAC ID 1153787007, 3 clinicians

Practice addresses (Care Compare)

6559 Wilson Mills Rd
Suite 106
Mayfield Village, OH 44143-3433
Phone (855) 449-1540

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.025741OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Dec 1, 2021 Accepting new patients
Atrium Medical Group, Inc CurrentSince Aug 1, 2022 Accepting new patients
Mukunda Medical Group LLC CurrentSince Jul 1, 2023 Accepting new patients

Locations

10201 Carnegie Ave
Cleveland, OH 44106
Phone (216) 445-2124

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

6559 Wilson Mills Rd
Mayfield Village, OH 44143
Phone (440) 461-0651

6559 Wilson Mills Rd
Ste 106A
Mayfield Village, OH 44143
Phone (216) 264-6603

6559 Wilson Mills Rd
Ste 106
Mayfield Vlg, OH 44143
Phone (855) 449-1540

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1572134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1912540543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 952041",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441920051",
            "telephone_number": "855-449-1540",
            "fax_number": "440-672-5068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6559 WILSON MILLS RD STE 106A",
            "city": "MAYFIELD VILLAGE",
            "state": "OH",
            "postal_code": "441433433",
            "telephone_number": "855-449-1540",
            "fax_number": "440-672-5068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECESARE",
        "first_name": "LYNDSEY",
        "middle_name": "RACHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-27",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.025741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNDSEY",
            "last_name": "KYTTA",
            "middle_name": "RACHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mayfield Village, OH

Sources for this page

Verify at the official NPI Registry.