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MARYMOUNT HOSPITAL, INC.
NPI 1720031131
Pathology - Anatomic Pathology & Clinical Pathology in Garfield Heights, OH

Active since May 18, 2006
12300 MCCRACKEN RD, GARFIELD HEIGHTS, OH 44125(216) 587-8686(216) 587-8274 Get Directions Write a Review

NPPES record last updated: August 25, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Marymount Hospital, Inc. NPPES

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

MARYMOUNT HOSPITAL, INC. (NPI 1720031131) is a healthcare organization registered as an anatomic pathology & clinical pathology in Garfield Heights, Ohio and active in the NPI registry since May 2006. The organization lists Dennis Laraway, Executive Vp Chief Finance Officer, as its authorized official.

NPPES Registry Identity

NPI1720031131
Entity TypeOrganization
Primary Taxonomy207ZP0102X
Legal Business NameMARYMOUNT HOSPITAL, INC.
Location Address12300 MCCRACKEN RDGarfield Heights, OH 44125-2914
Mailing Address12300 Mccracken RdGarfield Hts, OH 44125-2914 · (216) 587-8146 · Fax (216) 587-8831
Phone(216) 587-8686
Fax(216) 587-8274
Organization SubpartNo
Authorized OfficialDennis LarawayExecutive Vp Chief Finance Officer · (216) 445-1343
Enumeration DateMay 18, 2006
Last NPPES UpdateAugust 25, 2025
NPPES CertifiedAugust 25, 2025
✔ NPI 1720031131 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ZP0102X
Definition
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
12300 MCCRACKEN RD, Garfield Heights, OH 44125
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Other Identifiers 1

Medicaid2141677OH

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marymount Hospital, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

16

Medicare enrollment records show 16 clinicians reassign Medicare billing to Marymount Hospital, Inc., which bills Medicare for the services they deliver. Of these, 10 practice at this address and 16 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 2

Nurse Practitioner15
Certified Clinical Nurse Specialist (CNS)1

Clinicians, nearest first (16)

Jennifer Cole, APRN-CNP
Nurse Practitioner
NPI 1932099827
12300 MCCRACKEN RD
Garfield Heights, OH 44125
(216) 584-4344
✔ PECOS✔ Accepts MedicareSame address
Meghan Kestner, CNP
Nurse Practitioner
NPI 1508303751
12300 MCCRACKEN RD
Garfield Heights, OH 44125
(216) 581-0500
✔ PECOS✔ Accepts MedicareSame address
Tatyana Kligman
Nurse Practitioner
NPI 1205297678
12300 MCCRACKEN RD
Garfield Heights, OH 44125
(216) 581-0500
✔ PECOS✔ Accepts MedicareSame address
Sheila Matosky, CNP
Nurse Practitioner
NPI 1124376140
12300 MCCRACKEN RD
Garfield Hts, OH 44125
(216) 587-8724
✔ PECOS✔ Accepts MedicareSame address
Darleen Myers
Nurse Practitioner
NPI 1770943912
12300 MCCRACKEN RD
Garfield Heights, OH 44125
(216) 581-0500
✔ PECOS✔ Accepts MedicareSame address
Deanna Petsas
Certified Clinical Nurse Specialist (CNS)
NPI 1760839070
12300 MCCRACKEN RD
Garfield Heights, OH 44125
(330) 720-6388
✔ PECOS✔ Accepts MedicareSame address
Jennifer Scholle
Nurse Practitioner
NPI 1871243162
12300 MCCRACKEN RD
Cleveland, OH 44125
(216) 581-0500
✔ PECOS✔ Accepts MedicareSame address
Brenton Wagner, CNP
Nurse Practitioner
NPI 1326539578
12300 MCCRACKEN ROAD
Garfield Heights, OH 44125
(216) 581-0500
✔ PECOS✔ Accepts MedicareSame address
Lisa Kodek, CNP
Nurse Practitioner
NPI 1790762466
12300 MCCRACKEN RD
Garfield Hts, OH 44125
(216) 581-0500
✔ PECOS✔ Accepts MedicareSame address
Tera Street, CNP
Nurse Practitioner
NPI 1740662386
12300 MCCRACKEN RD
Garfield Heights, OH 44125
(216) 581-0500
✔ PECOS✔ Accepts MedicareSame address
John Allison
Nurse Practitioner
NPI 1306326939
12300 MCKRAKEN ROAD
Garfield Heights, OH 44125
(216) 704-1177
✔ PECOS✔ Accepts MedicareSame address
Lee Niro, CNP
Nurse Practitioner
NPI 1023093242
12300 MCCRACKEN RD
Garfield Hts, OH 44125
(216) 581-0500
✔ PECOSSame address
Lauren Taylor, CNP
Nurse Practitioner
NPI 1215404736
MARYMOUNT HOSPITAL 12300 MCCRACKEN ROAD
Garfield Heights, OH 44125
(216) 581-0500
✔ PECOS✔ Accepts Medicare0.5 mi
Shanice Morrison, MSN, APRN, FNP-C
Nurse Practitioner
NPI 1275241002
9500 EUCLID AVE
Cleveland, OH 44195
(216) 445-1927
✔ PECOS✔ Accepts Medicare5.8 mi
Andre Roman, APRN
Nurse Practitioner
NPI 1265915052
9500 EUCLID AVE
Cleveland, OH 44195
(800) 223-2273
✔ PECOS✔ Accepts Medicare5.8 mi
Anita Petrovic, NP
Nurse Practitioner
NPI 1770915506
1001 LAKESIDE AVE E STE 1000
Cleveland, OH 44114
(216) 645-2829
✔ PECOS✔ Accepts Medicare7.6 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marymount Hospital, Inc.'s NPI number?

The NPI number for Marymount Hospital, Inc. is 1720031131. It was assigned to this organization in the NPPES registry on May 18, 2006.

Where is Marymount Hospital, Inc. located?

Marymount Hospital, Inc. is located at 12300 Mccracken Rd, Garfield Heights, OH 44125. The listed phone number is (216) 587-8686.

What is Marymount Hospital, Inc.'s specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Is Marymount Hospital, Inc. enrolled in Medicare?

Yes. Marymount Hospital, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Marymount Hospital, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 16 clinicians in 2 Medicare specialties reassign their Medicare billing to Marymount Hospital, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (15) and Certified Clinical Nurse Specialist (CNS) (1). Of these, 10 practice at this address and 16 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Marymount Hospital, Inc. was last updated on August 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.