NPIMap

Organization Active NPI

University Primary Care Practices Inc

  • Gastroenterology Physician
  • Mentor, OH
National Provider Identifier
1003935339
Registry record updated Apr 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
UNIVERSITY PRIMARY CARE PRACTICES INC
Practice address
9000 Mentor Ave Ste 204
Mentor, OH 44060-4496
Phone
(216) 383-0100
Fax
(216) 383-6481
NPI assigned
Mar 28, 2007
Last updated
Apr 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2010

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

Authorized official

Name
Steve Riddle
Title
Director of Billing Services
Phone
(216) 383-6480

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X Primary

Addresses

Primary practice location

9000 Mentor Ave Ste 204
Mentor, OH 44060-4496

Mailing address

PO Box 8792
Belfast, ME 04915-8792
Phone (216) 383-6776

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031125000767 OH Part B Supplier - Clinic/Group Practice 3072417534 Receives reassigned benefits from 1,508 practitioners

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1,512

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 1,512

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270771200000",
    "number": "1003935339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8792",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049158792",
            "telephone_number": "216-383-6776",
            "fax_number": "216-383-6745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 MENTOR AVE STE 204",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604496",
            "telephone_number": "216-383-0100",
            "fax_number": "216-383-6481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PRIMARY CARE PRACTICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2010-04-09",
        "status": "A",
        "authorized_official_last_name": "RIDDLE",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING SERVICES",
        "authorized_official_telephone_number": "216-383-6480"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2010; 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.