Organization Active NPI

Advanced Womens Health and Surgery LLC

  • Gynecology Physician
  • Westlake, OH
National Provider Identifier
1003479288
Registry record updated Apr 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
ADVANCED WOMENS HEALTH AND SURGERY LLC
Practice address
25200 Center Ridge Rd
Westlake, OH 44145-4141
Phone
(216) 296-0458
NPI assigned
Apr 15, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Habibeh Gitiforooz, MDNPI 1912959909
Title
Owner
Phone
(216) 296-0458

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X Primary

Addresses

Primary practice location

25200 Center Ridge Rd
Westlake, OH 44145-4141

Mailing address

PO Box 314
Chagrin Falls, OH 44022-0314

Other identifiers 1

IdentifierTypeStateIssuer
2229127MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190715003208 OH Part B Supplier - Clinic/Group Practice 0749515641 Receives reassigned benefits from 2 practitioners
Practice locations: Westlake, OH

National Provider Directory

National Provider Directory

Locations

27877 Clemens Rd
Westlake, OH 44145
Phone (216) 226-8700

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555286400000",
    "number": "1003479288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 314",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440220314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25200 CENTER RIDGE RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441454141",
            "telephone_number": "216-296-0458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED WOMENS HEALTH AND SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-15",
        "last_updated": "2019-04-15",
        "status": "A",
        "authorized_official_last_name": "GITIFOROOZ",
        "authorized_official_first_name": "HABIBEH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-296-0458",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2229127",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.