Individual provider Active NPI

Autumn Metzger, PA-C

  • Physician Assistant
  • Warren, OH
National Provider Identifier
1962832733
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.003944 Issued in OH
Practice address
103 W Market St
Warren, OH 44481-1017
Phone
(330) 394-8831
NPI assigned
Nov 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.003944 OH Primary

Addresses

Primary practice location

103 W Market St
Warren, OH 44481-1017

Mailing address

5982 Rhodes Rd
Kent, OH 44240-8100
Phone (724) 813-0518

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
I20140324000867 OH Practitioner - Physician Assistant 4688805336 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coleman Professional Services, Inc.Group PAC ID 2769474618, 64 clinicians

Practice addresses (Care Compare)

5982 Rhodes Rd
Kent, OH 44240-8100
Phone (330) 673-1347

611 Belmont Ave
Youngstown, OH 44502-1037
Phone (330) 744-2991

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50.003944OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spero Health of Ohio, LLC PastSince Jun 21, 2022 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1384473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1962832733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5982 RHODES RD",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442408100",
            "telephone_number": "724-813-0518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W MARKET ST",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444811017",
            "telephone_number": "330-394-8831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METZGER",
        "first_name": "AUTUMN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-15",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.