NPIMap

Individual provider Active NPI

Khaleel Deeb, MD

  • Family Medicine Physician
  • Brooklyn, OH
National Provider Identifier
1053387761
Registry record updated Nov 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35060323D Issued in OH
Practice address
7575 Northcliff Ave
Suite 304
Brooklyn, OH 44144-3267
Phone
(216) 749-8265
Fax
(216) 749-8222
NPI assigned
Feb 23, 2006
Last updated
Nov 28, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2018

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 35060323D OH Primary

Addresses

Primary practice location

7575 Northcliff Ave
Suite 304
Brooklyn, OH 44144-3267

Mailing address

3535 Lee Rd
Shaker Heights, OH 44120-5122
Phone (216) 417-6166

Other identifiers 16

IdentifierTypeStateIssuer
080097144OtherOHRAILROAD MEDICARE
102976OtherOHKAISER
4255074OtherOHAETNA
9273172OtherOHMEDICARE GROUP
3610861OtherOHASC MEDICARE GROUP
10790454OtherOHCAQH
0880186MedicaidOH
CA4511OtherRR MEDICARE GROUP
F60323OtherSUMMACARE APEX
000000031846OtherANTHEM
1780634279OtherGROUP NPI
34-1783OtherGROUP TIN
341783789036OtherCARE SOURCE
D368301OtherOHDIAGNOSTIC GROUP MEDICARE
102976OtherKAISER
10790454OtherCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041029000046 OH Practitioner - Family Practice 7214999598 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Physicians Centers IncGroup PAC ID 0345153326, 50 clinicians

Practice addresses (Care Compare)

1730 W 25TH St
Cleveland, OH 44113-3108
Phone (440) 331-4646

18697 Bagley Rd
A317
Middleburg Heights, OH 44130-3417
Phone (440) 816-6030

25200 Ctr Ridge Rd
Westlake, OH 44145-4142

25200 Ctr Ridge Rd
Suite 2300
Westlake, OH 44145-4148
Phone (440) 331-5053

25200 Ctr Ridge Rd
Suite 2400
Westlake, OH 44145-4152
Phone (440) 333-3332

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35060323DOHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Encore Clinical Services LLC Family Medicine Current Accepting new patients
Premier Physicians Centers Inc CurrentSince Nov 9, 2009 Accepting new patients
Lake Effect Health CurrentSince Sep 1, 2024 Accepting new patients
Premier Physicians Centers, Inc. Family Medicine CurrentSince Nov 9, 2009 Accepting new patients
Healix Wound LLC CurrentSince Nov 1, 2024 Accepting new patients
Northridge Post Acute Care LLC Past Accepting new patients
Lutheran Hospital Past Accepting new patients
Fairview Hospital Past Accepting new patients
Avon Nursing LLC Past Accepting new patients
Middleburg Heights Nursing Home LLC Past Accepting new patients
Twinsburg SNF Healthcare LLC Past Accepting new patients
Aj Cityview Nursing & Rehab Opco LLC Past Accepting new patients
Cardinal Avon, Inc. Past Accepting new patients
Garden Healthcare of Rocky River LLC Past Accepting new patients
Aristos Opco LLC Past Accepting new patients
Mount Royal Villa LLC Past Accepting new patients
Buckeye Forest at North Olmstead LLC Past Accepting new patients
Buckeye Forest at Mayfield Heights LLC Past Accepting new patients

Locations

12409 Lorain Ave
Ste 100
Cleveland, OH 44111
Phone (216) 251-9066

3611 Prospect Ave E
Cleveland, OH 44115
Phone (216) 205-4862

7575 Northcliff Ave
Ste 103
Cleveland, OH 44144
Phone (216) 205-4862

7575 Northcliff Ave
Ste 304
Cleveland, OH 44144
Phone (216) 351-0778

15000 Madison Ave
Lakewood, OH 44107
Phone (216) 221-7642

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 2300
Westlake, OH 44145
Phone (440) 331-5053

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 11

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1053387761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 LEE RD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441205122",
            "telephone_number": "216-417-6166",
            "fax_number": "216-417-8676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7575 NORTHCLIFF AVE",
            "address_2": "SUITE 304",
            "city": "BROOKLYN",
            "state": "OH",
            "postal_code": "441443267",
            "telephone_number": "216-749-8265",
            "fax_number": "216-749-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEEB",
        "first_name": "KHALEEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35060323D",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080097144",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "102976",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4255074",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "9273172",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASC MEDICARE GROUP",
            "identifier": "3610861",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10790454",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0880186",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "CA4511",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUMMACARE APEX",
            "identifier": "F60323",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000031846",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1780634279",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP TIN",
            "identifier": "34-1783",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE SOURCE",
            "identifier": "341783789036",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIAGNOSTIC GROUP MEDICARE",
            "identifier": "D368301",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "102976",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10790454",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, OH

Sources for this page

Verify at the official NPI Registry.