Anita Bhalla, MD
Individual provider Active NPI Infectious Disease Physician · Lakewood, OH
NPI 1013983790 · NPPES record last updated Apr 23, 2009
Key facts
- NPI
- 1013983790
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Infectious Disease Physician 207RI0200X
- License
- 35078416B (OH)
- Practice address
- 15000 Madison Ave
Lakewood, OH 44107 - Phone
- (216) 472-1404
- Fax
- (216) 529-7806
- NPI assigned
- Feb 23, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Infectious Disease
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Premier Physicians Centers Inc
Practice addresses (Care Compare)
25200 Ctr Ridge Rd
Suite 2300
Westlake, OH 44145-4148
Phone (440) 331-3356
Hospital & facility affiliations
- Fairview Hospital
- Cleveland Clinic
- Lutheran Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040427000862 | OH | Practitioner - Infectious Disease |
3072500628 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35078416B | OH | MD | Infectious Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Physicians Centers, Inc. | Current |
Accepting new patients | |
| Premier Physicians Centers Inc | Current |
Accepting new patients | |
| Gagan C Mallik MD Inc | Past | Accepting new patients | |
| Premier Comprehensive Management Services, LLC | Past | Accepting new patients |
Locations
15000 Madison Ave
Lakewood, OH 44107
Phone (216) 221-7642
20525 Center Ridge Rd
Ste 220
Rocky River, OH 44116
Phone (440) 895-5021
20525 Center Ridge Rd
Ste 400
Rocky River, OH 44116
Phone (440) 331-0747
24500 Center Ridge Rd
Ste 375
Westlake, OH 44145
Phone (440) 467-1954
24651 Center Ridge Rd
Ste 350
Westlake, OH 44145
Phone (440) 328-4949
25200 Center Ridge Rd
Ste 2600
Westlake, OH 44145
Phone (440) 331-5488
25200 Center Ridge Rd
Ste 2300
Westlake, OH 44145
Phone (440) 331-5053
29099 Health Campus Dr
Ste 290
Westlake, OH 44145
Phone (440) 243-6660
25200 Center Ridge Rd
Ste 2000
Westlake, OH 44145
Phone (216) 472-1404
Interoperability endpoints
- abhalla36021@ehrdirect.uhhospitals.org
- anita.bhalla@ppc2.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | 35078416B | OH | Yes |
Addresses
Primary practice location
15000 Madison Ave
Lakewood, OH 44107
Mailing address
20525 Center Ridge Road
Suite 220
Rocky River, OH 44116
Phone (440) 895-5042
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000593931 | Other | OH | ANTHEM |
| 9200381 | Other | UNITED HEALTHCARE | |
| C78416 | Other | SUMMACARE APEX | |
| 9273172 | Other | OH | GROUP MEDICARE PTAN |
| 7007606 | Other | AETNA | |
| 0119204 | Other | OH | MEDICAID GROUP NUMBER |
| 000000342372 | Other | ANTHEM | |
| 2488099 | Medicaid | OH |
Other providers in Lakewood, OH
- Richard Lee Bernhardt
- Rebecca E Berry
- Emily Beskid
- Colleen Katherine Beyer
- BG Antar, LLC
- Anu Bhargava
- Elizabeth K. Biddulph
- Wendy Biello
- Donna Holmes Bishop
- Christina N Bistransky
All providers in Lakewood, OH · Infectious Disease Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.