Individual provider Active NPI

Jacob Robert Bryan, MD

  • Neuroradiology Physician
  • Cleveland, OH
National Provider Identifier
1023645199
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
35.144179 Issued in OH
Practice address
9500 Euclid Ave
Cleveland, OH 44195-0002
Phone
(216) 444-2200
NPI assigned
Mar 26, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 35.144179 OH Primary
Diagnostic Neuroimaging (Radiology) Physician 2085D0003X 35.144179 OH
Diagnostic Radiology Physician 2085R0202X 35.144179 OH

Addresses

Primary practice location

9500 Euclid Ave
Cleveland, OH 44195-0002

Mailing address

9500 Euclid Ave
Cleveland, OH 44195-0002
Phone (216) 444-2200

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
I20200709001293 OH Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4183047178

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.144179OHMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1023645199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950002",
            "telephone_number": "216-444-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950002",
            "telephone_number": "216-444-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "JACOB",
        "middle_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "OH",
            "license": "35.144179",
            "primary": true
        },
        {
            "code": "2085D0003X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Neuroimaging",
            "state": "OH",
            "license": "35.144179",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35.144179",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.