Individual provider Active NPI

Nancy Wasserbauer Kingston, DO

  • Allergy & Immunology Physician
  • Rocky River, OH
National Provider Identifier
1922022524
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
34008802 Issued in OH
Practice address
19800 Detroit Rd
Rocky River, OH 44116-1816
Phone
(440) 333-1107
Fax
(440) 333-1064
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 34008802 OH Primary

Addresses

Primary practice location

19800 Detroit Rd
Rocky River, OH 44116-1816

Mailing address

26908 Detroit Rd
Suite 301
Westlake, OH 44145-2398
Phone (440) 617-1823

Other identifiers 1

IdentifierTypeStateIssuer
2680915MedicaidOH

Other names 1

  • Nancy Wasserbauer Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nancywasserbauer@uhps.allscriptsdirect.net

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
I20061010000144 OH Practitioner - Allergy/ImmunologyPractitioner - Pediatric MedicinePractitioner - Emergency Medicine 1658377924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Pediatric Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

158 W Main Rd
Conneaut, OH 44030-2039

5901 E Royalton Rd
Broadview Heights, OH 44147-3532

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.15 of 100Reported as apm
Quality
82.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34008802OHMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc CurrentSince Jan 18, 2017 Accepting new patients
University Primary Care Practices Inc Current Accepting new patients
University Primary Care Practices Inc CurrentSince Jan 18, 2017 Accepting new patients
Allergy & Asthma Center of Northeast Ohio Past Accepting new patients
University Primary Care Practices Past Accepting new patients

Locations

2535 Hale St
Ste B
Avon, OH 44011
Phone (440) 934-8858

5901 E Royalton Rd
Ste 2300
Broadview Heights, OH 44147
Phone (216) 529-6180

11100 Euclid Ave
Cleveland Heights, OH 44106

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

29325 Health Campus Dr
Ste 2
Westlake, OH 44145
Phone (440) 835-6142

29000 Center Ridge Rd
Westlake, OH 44145
Phone (440) 414-6046

Interoperability endpoints

  • Direct secure messaging: nwasserbauerkingston35951@ehrdirect.uhhospitals.org

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 4

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1922022524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26908 DETROIT RD",
            "address_2": "SUITE 301",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441452398",
            "telephone_number": "440-617-1823",
            "fax_number": "440-617-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19800 DETROIT RD",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441161816",
            "telephone_number": "440-333-1107",
            "fax_number": "440-333-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERBAUER KINGSTON",
        "first_name": "NANCY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "OH",
            "license": "34008802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2680915",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nancywasserbauer@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "19800 Detroit Rd",
            "city": "Rocky River",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441161816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "WASSERBAUER",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Rocky River, OH

Sources for this page

Verify at the official NPI Registry.