DataLabs

datalabs.health made in the usa

Contact us Sign in | Documentation |

divider

Medicare/Medicaid Verification Programs divider

divider

Medicare Verification Program divider

divider

1942285218

NPI Code Detail

MEDICARE: JEANETTE PORUBOVICH-MIZENKO MD

MEDICARE: JEANETTE PORUBOVICH-MIZENKO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	35-05-5955-P	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CN3937	OTHER	OH	RAILROAD MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	2228330	OTHER	OH	AETNA
4	000000028998	OTHER	OH	ANTHEM
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	80207	OTHER	OH	QUAL CHOICE

General Provider Information

NPI Number	:	1942285218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANETTE PORUBOVICH-MIZENKO MD

Provider Business Mailing Address
First Line	:	PO BOX 30076
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44130-0076
Country	:	US
Telephone Number	:	440-816-5379
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 W WATERLOO RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44319-1116
Country	:	US
Telephone Number	:	330-724-7715
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	09/04/2012

Similar Medicare Providers

1134179799 — CLEVELAND VAMC
Practice Location Address:

55 W WATERLOO RD
AKRON, OH
44319-1116

Practice Phone: 608-821-7200
Practice Fax: 608-821-7658

1629003306 — DR. JEFFREY LEE HALPERT D.P.M.
Practice Location Address:

55 W WATERLOO RD
AKRON, OH
44319-1116

Practice Phone: 330-724-7715
Practice Fax: 330-724-1029

1942228341 — DR. JENNIFER ANN CHOATE O.D.
Practice Location Address:

55 W WATERLOO RD
AKRON, OH
44319-1116

Practice Phone: 330-724-7715
Practice Fax: 330-724-1029

1922022979 — KATHLEEN SUE DETAMORE RD, LD
Practice Location Address:

55 W WATERLOO RD
AKRON, OH
44319-1116

Practice Phone: 330-724-7715
Practice Fax: 330-724-1080

1780695544 — CANDACE JAYNE BIRD RD
Practice Location Address:

55 W WATERLOO RD
AKRON, OH
44319-1116

Practice Phone: 330-724-7715
Practice Fax: 330-724-1029

1861404634 — DR. ERIC JAGAR MD
Practice Location Address:

55 W WATERLOO RD
AKRON, OH
44319-1116

Practice Phone: 330-724-7715
Practice Fax: 330-724-1029

Directions to “ JEANETTE PORUBOVICH-MIZENKO MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.