PROFESSIONAL PROVIDER SERVICES LLC – Nurse Practitioner, NPI 1598522690
Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for PROFESSIONAL PROVIDER SERVICES LLC
38642 CENTER RIDGE RD
NORTH RIDGEVILLE, OH 440395812
Phone: (440) 387-5500
Type: Location
4800 Clague Rd
North Olmsted, OH 440706207
Phone: (440) 734-9933
Type: Location
20770 Lorain Rd
Fairview Park, OH 441262019
Phone: (440) 331-0300
Type: Location
38600 Center Ridge Rd
North Ridgeville, OH 440392837
Phone: (440) 327-1295
Type: Location
13900 Detroit Ave
Lakewood, OH 441074624
Phone: (216) 228-7650
Type: Location
605 Bradley Rd
Bay Village, OH 441401670
Phone: (440) 871-3474
Type: Location
7250 Old Oak Blvd
Middleburg Heights, OH 441303341
Phone: (440) 243-7888
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-01-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20250130002102 | O | Clinic/Group Practice | OH | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 44039)
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Reviews
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