Individual provider Active NPI

Mark H Gersten, MD

  • Emergency Medicine Physician
  • Beachwood, OH
National Provider Identifier
1003929555
Registry record updated Mar 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35058857 Issued in OH
Practice address
3909 Orange PL
Ste 2100
Beachwood, OH 44122-4478
Phone
(216) 896-1800
Fax
(216) 896-1801
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35058857 OH Primary

Addresses

Primary practice location

3909 Orange PL
Ste 2100
Beachwood, OH 44122-4478

Mailing address

20800 Harvard Rd
2ND FLR
Highland Hills, OH 44122-7251

Other identifiers 1

IdentifierTypeStateIssuer
0807569MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, VT, CT, NY4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20090622000679 OH Practitioner - Emergency Medicine 4789631425 Reassigns benefits to 2 organizations
I20230919003680 VT Practitioner - Emergency Medicine 4789631425 Reassigns benefits to 1 organization
I20230920001668 CT Practitioner - Emergency Medicine 4789631425
I20231012002777 NY Practitioner - Emergency Medicine 4789631425

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
318480NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Cleveland Clinic Mercy Hospital CurrentSince Apr 22, 2009 Accepting new patients
Virtualcare Medical Group PA CurrentSince Sep 15, 2025 Accepting new patients
Openloop Healthcare Partners New Jersey PC CurrentSince Jul 28, 2023 Accepting new patients
University Primary Care Practices Inc. Past Accepting new patients
Multicare Health System Past Accepting new patients

Locations

175 Capital Blvd
Fl 4
Rocky Hill, CT 06067
Phone (860) 380-0452

317 6th Ave
Ste 400
Des Moines, IA 50309
Phone (515) 612-9097

820 Bear Tavern Rd
Ewing, NJ 08628
Phone (415) 205-1229

1330 Mercy Dr NW
Ste 200
Canton, OH 44708
Phone (330) 489-1000

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456876800000",
    "number": "1003929555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20800 HARVARD RD",
            "address_2": "2ND FLR",
            "city": "HIGHLAND HILLS",
            "state": "OH",
            "postal_code": "441227251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 ORANGE PL",
            "address_2": "STE 2100",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224478",
            "telephone_number": "216-896-1800",
            "fax_number": "216-896-1801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERSTEN",
        "first_name": "MARK",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2016-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35058857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0807569",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.