SUSAN LACEY ANTONELLI NP-C
NPI 1477033918
Nurse Practitioner - Gerontology in Cleveland, OH

Q: What is Susan Antonelli's NPI number?

The NPI number for Susan Antonelli is 1477033918. It was assigned to this individual provider in the NPPES registry on August 15, 2018.

Q: What is Susan Antonelli's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: When was this NPI record last updated?

The NPPES record for Susan Antonelli was last updated on June 20, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 15, 2018PECOS Enrolled

17876 SAINT CLAIR AVE, CLEVELAND, OH 44110(216) 383-2222(216) 298-0241 Get Directions Write a Review

NPPES record last updated: June 20, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 20, 2019, Aug 15, 2018 (2 updates tracked since 2018).

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About Susan Lacey Antonelli Np-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUSAN LACEY ANTONELLI NP-C (NPI 1477033918) is an individual gerontology provider in Cleveland, Ohio, licensed in Ohio (APRN.CNP.023456) and active in the NPI registry since August 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1477033918

Entity TypeIndividualFemale

Primary Taxonomy363LG0600X

Provider Legal NameSUSAN LACEY ANTONELLICredential: NP-C

Location Address17876 SAINT CLAIR AVECleveland, OH 44110-2602

Mailing Address17876 Saint Clair AveCleveland, OH 44110-2602 · (216) 383-2222 · Fax (216) 298-0241

Phone(216) 383-2222

Fax(216) 298-0241

Sole ProprietorNo

Enumeration DateAugust 15, 2018

Last NPPES UpdateJune 20, 20192 updates tracked since enumeration

✔ NPI 1477033918 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in OH · APRN.CNP.023456

17876 SAINT CLAIR AVE, Cleveland, OH 44110

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, MedMutual, Oscar Insurance Corporation of Ohio.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Susan Lacey Antonelli Np-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44110 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.72 typical visit price

range $54.34 – $166.65

Typical copayment $21.18 (range $13.58 – $41.66)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.10 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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