Individual provider Active NPI

Julie Elizabeth Diegelmann, PA-C

  • Physician Assistant
  • Middleburg Heights, OH
National Provider Identifier
1962872119
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.005111RX Issued in OH
Practice address
18660 Bagley Rd
Building 1, Suite 501
Middleburg Heights, OH 44130-3483
Phone
(440) 482-8424
Fax
(440) 808-1718
NPI assigned
Sep 30, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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 50.005111RX OH Primary

Addresses

Primary practice location

18660 Bagley Rd
Building 1, Suite 501
Middleburg Heights, OH 44130-3483

Mailing address

2205 Crocker Rd Ste 109
Westlake, OH 44145-6710
Phone (440) 249-0274

Other practice location 1

2205 Crocker Rd Ste 109
Westlake, OH 44145-6710
Phone (440) 482-8323

Other names 1

  • Miss Julie Elizabeth Spehar 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
I20171010001517 OH Practitioner - Physician Assistant 1759682545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associates in Dermatology, Inc.Group PAC ID 2668495409, 11 clinicians

Practice addresses (Care Compare)

2205 Crocker Rd
Suite 109
Westlake, OH 44145-6710
Phone (440) 249-0274

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.005111RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
James River Dermatology PLLC Past Accepting new patients
CH Specialty Services TX PLLC PastSince Sep 1, 2024 Accepting new patients
James River Dermatology PLLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AGCHAA

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1962872119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 CROCKER RD STE 109",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441456710",
            "telephone_number": "440-249-0274",
            "fax_number": "440-808-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18660 BAGLEY RD",
            "address_2": "BUILDING 1, SUITE 501",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303483",
            "telephone_number": "440-482-8424",
            "fax_number": "440-808-1718"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2205 Crocker Rd Ste 109",
            "address_purpose": "LOCATION",
            "city": "Westlake",
            "state": "OH",
            "postal_code": "441456710",
            "country_code": "US",
            "telephone_number": "440-482-8323",
            "fax_number": "440-808-1718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIEGELMANN",
        "first_name": "JULIE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-30",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005111RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "SPEHAR",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Middleburg Heights, OH

Sources for this page

Verify at the official NPI Registry.