NPIMap

Organization Active NPI

Cleveland Orthopedic and Spine Institute, LLC

  • Clinic/Center
  • Mayfield Heights, OH
National Provider Identifier
1033988928
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
CLEVELAND ORTHOPEDIC AND SPINE INSTITUTE, LLC
Practice address
300 Allen Bradley Dr Ste 200
Mayfield Heights, OH 44124-6130
Phone
(844) 746-8537
NPI assigned
Dec 20, 2023
Last updated
Apr 14, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
CLEVELAND ORTHOPEDIC AND SPINE INSTITUTE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Authorized official

Name
Mary Ebert
Title
Compliance Officer
Phone
(614) 260-2357

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Clinic/Center 261Q00000X Primary
Physical Therapy Clinic/Center 261QP2000X
Radiology Clinic/Center 261QR0200X
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

300 Allen Bradley Dr Ste 200
Mayfield Heights, OH 44124-6130

Mailing address

300 Allen Bradley Dr Ste 200
Mayfield Heights, OH 44124-6130
Phone (407) 307-7652

Other names 1

  • Mark R. Grubb, MD, Inc Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130510000603 OH DME Supplier - Physician - General Practice 4880590413 1 other NPI on this enrollment
Practice locations: Mayfield Heights, OH
O20240917000749 OH Part B Supplier - Clinic/Group Practice 4880590413 Receives reassigned benefits from 20 practitioners
Practice locations: Beachwood, OH; Mayfield Heights, OH; Whitehall, OH

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Cleveland Orthopedic and Spine Institute LLC4 organizations share this tax ID, including this one
Part of
Cleveland Orthopedic and Spine Institute LLC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

300 Allen Bradley Dr
Ste 120
Mayfield Heights, OH 44124

300 Allen Bradley Dr
Ste 200
Mayfield Heights, OH 44124
Phone (407) 307-7652

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 20

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 20

NPI Registry JSON

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

{
    "created_epoch": "1703030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744588800000",
    "number": "1033988928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 ALLEN BRADLEY DR STE 200",
            "city": "MAYFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441246130",
            "telephone_number": "407-307-7652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ALLEN BRADLEY DR STE 200",
            "city": "MAYFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441246130",
            "telephone_number": "844-746-8537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND ORTHOPEDIC AND SPINE INSTITUTE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLEVELAND ORTHOPEDIC AND SPINE INSTITUTE, LLC",
        "enumeration_date": "2023-12-20",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A",
        "authorized_official_last_name": "EBERT",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "614-260-2357"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mark R. Grubb, MD, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Mayfield Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; 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.