Individual provider Active NPI

Suresh Kumar Mahajan, M.D.

  • Gastroenterology Physician
  • Cleveland, OH
National Provider Identifier
1003908047
Registry record updated Dec 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
35-05-8230 Issued in OH
Practice address
7255 Old Oak Blvd
C101
Cleveland, OH 44130-3329
Phone
(440) 816-2789
Fax
(440) 816-2811
NPI assigned
Sep 28, 2006
Last updated
Dec 10, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 35058230 OH
Gastroenterology Physician 207RG0100X 35-05-8230 OH Primary

Addresses

Primary practice location

7255 Old Oak Blvd
C101
Cleveland, OH 44130-3329

Mailing address

7255 Old Oak Blvd
C101
Cleveland, OH 44130-3329
Phone (440) 816-2789

Other identifiers 1

IdentifierTypeStateIssuer
0198263MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040601000006 OH Practitioner - Gastroenterology 0749261394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Physicians Centers IncGroup PAC ID 0345153326, 50 clinicians

Practice addresses (Care Compare)

18697 Bagley Rd
A317
Middleburg Heights, OH 44130-3417
Phone (440) 816-6030

25200 Ctr Ridge Rd
Suite 2300
Westlake, OH 44145-4148
Phone (440) 331-5053

7255 Old Oak Blvd
Suite C112
Middleburg Heights, OH 44130-3329
Phone (440) 816-5517

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy366
Upper gastrointestinal (GI) endoscopy for acid reflux333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35058230OHMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Physicians Centers, Inc. CurrentSince Jul 1, 2024 Accepting new patients
Premier Physicians Centers Inc CurrentSince Jul 1, 2024 Accepting new patients
Premier Physicians Centers, Inc. Current Accepting new patients
Subhash C. Mahajan, MD Inc Gastroenterology PastSince Apr 1, 1994 Accepting new patients

Locations

24500 Center Ridge Rd
Ste 375
Westlake, OH 44145
Phone (440) 467-1954

25200 Center Ridge Rd
Ste 2300
Westlake, OH 44145
Phone (440) 331-5053

Networks

  • KY PPO
  • devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9
  • devoted network organization-2d523d8e-e8f9-454a-bcd3-333df65bdbe8
  • KY PPO C-SNP
  • devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
  • devoted network organization-9f3dfbd3-4aa6-4c92-8e71-9c4ed35ce037
  • OH PPO

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EHFCAD/Endpoint/EHFCAD

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1003908047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7255 OLD OAK BLVD",
            "address_2": "C101",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441303329",
            "telephone_number": "440-816-2789",
            "fax_number": "440-816-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7255 OLD OAK BLVD",
            "address_2": "C101",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441303329",
            "telephone_number": "440-816-2789",
            "fax_number": "440-816-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAJAN",
        "first_name": "SURESH",
        "middle_name": "KUMAR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "35058230",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "35-05-8230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0198263",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.