Individual provider Active NPI

Jeffrey J Viscomi, M.D.

  • Family Medicine Physician
  • Strongsville, OH
National Provider Identifier
1013975077
Registry record updated Sep 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
201249527 Issued in OH
Practice address
10633 Pearl Rd
Strongsville, OH 44136-1435
Phone
(440) 846-6963
Fax
(440) 846-0011
NPI assigned
May 1, 2006
Last updated
Sep 23, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 201249527 OH Primary

Addresses

Primary practice location

10633 Pearl Rd
Strongsville, OH 44136-1435

Mailing address

10633 Pearl Rd
Strongsville, OH 44136-1435
Phone (440) 846-6963

Other identifiers 1

IdentifierTypeStateIssuer
0108949MedicaidOH

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
I20050107000093 OH Practitioner - Family Practice 8527016583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wright State University Boonshoft School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10633 Pearl Rd
Suite 1
Strongsville, OH 44136-1405
Phone (440) 846-6963

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Docere Physicians Inc. Family Medicine CurrentSince Jan 3, 2005 Accepting new patients

Locations

10633 Pearl Rd
Strongsville, OH 44136
Phone (440) 212-7677

10633 Pearl Rd
Ste 1
Strongsville, OH 44136
Phone (440) 846-6963

Organizations & group practices 2

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 2

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316736000000",
    "number": "1013975077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10633 PEARL RD",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441361435",
            "telephone_number": "440-846-6963",
            "fax_number": "440-846-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10633 PEARL RD",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441361435",
            "telephone_number": "440-846-6963",
            "fax_number": "440-846-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISCOMI",
        "first_name": "JEFFREY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2011-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "201249527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0108949",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Strongsville, OH

Sources for this page

Verify at the official NPI Registry.