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ERIESIDE MEDICAL GROUP
NPI 1891751657
Family Medicine in Willoughby, OH

Active since April 21, 2006CLIA 36D0897273 · Waiver
38429 LAKE SHORE BLVD, WILLOUGHBY, OH 44094(440) 946-9200 Get Directions Write a Review

NPPES record last updated: June 10, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Erieside Medical Group NPPES

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

ERIESIDE MEDICAL GROUP (NPI 1891751657) is a healthcare organization registered as a family medicine in Willoughby, Ohio and active in the NPI registry since April 2006. The organization holds a CLIA Waiver certificate valid through January 31, 2027 and lists Winston Ho, President, as its authorized official.

NPPES Registry Identity

NPI1891751657
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameERIESIDE MEDICAL GROUP
Location Address38429 LAKE SHORE BLVDWilloughby, OH 44094-7009
Mailing Address38429 Lake Shore BlvdWilloughby, OH 44094-7009 · (440) 946-9200
Phone(440) 946-9200
Organization SubpartNo
Authorized OfficialWinston HoPresident · (440) 269-7483
Enumeration DateApril 21, 2006
Last NPPES UpdateJune 10, 2010
✔ NPI 1891751657 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in OH · 35-052285D
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedInternal MedicineTaxonomy 207R00000X · License 35-06-5285H (OH), 34-003413F (OH)
Also ListedPediatrics · Adolescent MedicineTaxonomy 2080A0000X · License 35-06-1390M
38429 LAKE SHORE BLVD, Willoughby, OH 44094
Open in Google Maps ↗

Other Identifiers 4

Medicare UPINF59340OH
Medicare UPINC02730OH
Medicare UPINA16908OH
Medicare UPINF30444OH

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D0897273

Erieside Medical Group · Willoughby, OH
Active · expires Jan 31, 2027
CLIA Number36D0897273
Laboratory TypePhysician Office
Certificate Effective DateFebruary 1, 2025
Certificate Expiration DateJanuary 31, 2027
Laboratory DirectorWinston Ho
Laboratory Phone(440) 918-6274
Laboratory LocationErieside Medical Group38429 Lakeshore Blvd, Willoughby, OH 44094
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

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

MISS LAURA LEE FRYCKLUND NP
Nurse Practitioner (Adult Health)
38429 LAKE SHORE BLVD
WILLOUGHBY, OH 44094
Lake County (440) 269-7488
LEAH SOPKO CNP
Nurse Practitioner
38429 LAKE SHORE BLVD
WILLOUGHBY, OH 44094
Lake County (440) 269-7488
LABORATORY CORPORATION OF AMERICA HOLDINGS
Clinical Medical Laboratory
38429 LAKE SHORE BLVD
WILLOUGHBY, OH 44094
Lake County (440) 918-6285
DR. WINSTON HO MD
Internal Medicine
38429 LAKE SHORE BLVD
WILLOUGHBY, OH 44094
Lake County (440) 946-9200
DR. JAMES MANDELIK M.D.
Pediatrics
38429 LAKE SHORE BLVD
WILLOUGHBY, OH 44094
Lake County (440) 946-9200
TAWANA CUNNINGHAM
Nurse Practitioner (Family)
38429 LAKE SHORE BLVD
WILLOUGHBY, OH 44094
Lake County (440) 946-9200
MS. KLARA HITCHCOCK APRN
Nurse Practitioner (Family)
38429 LAKE SHORE BLVD
WILLOUGHBY, OH 44094
Lake County (440) 946-9200

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 Erieside Medical Group's NPI number?

The NPI number for Erieside Medical Group is 1891751657. It was assigned to this organization in the NPPES registry on April 21, 2006.

Where is Erieside Medical Group located?

Erieside Medical Group is located at 38429 Lake Shore Blvd, Willoughby, OH 44094. The listed phone number is (440) 946-9200.

What is Erieside Medical Group's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Erieside Medical Group hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D0897273) is associated with this NPI, valid through January 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Erieside Medical Group accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Anthem Blue Cross and Blue Shield list Erieside Medical Group as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Erieside Medical Group was last updated on June 10, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.