MEDICARE: DR. PATRICK ROBERT DENNISON D.O.

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	207Q00000X	Family Medicine Physician	34-0037799	OH
2	207Q00000X	Family Medicine Physician	276924-1	NY

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235370461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK ROBERT DENNISON D.O.

Provider Business Mailing Address
First Line	:	PO BOX 660
Second Line	:
City	:	MENTOR
State	:	OH
Zip	:	44061-0660
Country	:	US
Telephone Number	:	440-516-3776
Fax Number	:	440-516-3783

Provider Business Practice Location Address
First Line	:	5595 TRANSPORTATION BLVD STE 240
Second Line	:
City	:	GARFIELD HEIGHTS
State	:	OH
Zip	:	44125-5359
Country	:	US
Telephone Number	:	216-633-1334
Fax Number	:	216-465-9360

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

Provider Enumeration Date	:	03/18/2009
Last Update Date	:	02/18/2026

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