Carl Ansevin, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

90097 Issued in OH

Practice address

390 Timberidge TRL
Gates Mills, OH 44040-9319

Phone

(216) 554-5289

NPI assigned

Sep 16, 2006

Last updated

Feb 20, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Neurology

Education

Wright State University Boonshoft School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

American Neuromonitoring Associates, PCGroup PAC ID 8022019710, 30 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medstar Georgetown University Hospital Hospital, Washington, DC, CCN 090004
• Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171
• Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
• Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119
• New England Baptist Hospital Hospital, Boston, MA, CCN 220088

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• American Neuromonitoring Associates, PC

  • Neurology Physician
  • Columbia, MD
  • NPI 1740391283

  OH

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lahey Clinic Hospital, Inc.

  • General Acute Care Hospital
  • Burlington, MA
  • NPI 1558392563
  Care Compare affiliation
• Medstar - Georgetown Medical Center, Inc.

  dba Georgetown University Hospital

  • General Acute Care Hospital
  • Washington, DC
  • NPI 1427145176
  Care Compare affiliation
• New England Baptist Hospital

  • General Acute Care Hospital
  • Roxbury Crossing, MA
  • NPI 1699767491
  Care Compare affiliation
• Sentara Hospitals

  dba Sentara Nightingale

  • Air Ambulance
  • Norfolk, VA
  • NPI 1235205147

  Hospital

  Care Compare affiliation
• Sentara Hospitals

  dba Sentara Norfolk General Hospital

  • General Acute Care Hospital
  • Norfolk, VA
  • NPI 1437119310
  Care Compare affiliation
• Sentara Princess Anne Hospital

  • General Acute Care Hospital
  • Virginia Beach, VA
  • NPI 1528028396
  Care Compare affiliation

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1053417709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 TIMBERIDGE TRL",
            "city": "GATES MILLS",
            "state": "OH",
            "postal_code": "440409319",
            "telephone_number": "216-554-5289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 TIMBERIDGE TRL",
            "city": "GATES MILLS",
            "state": "OH",
            "postal_code": "440409319",
            "telephone_number": "216-554-5289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANSEVIN",
        "first_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OH",
            "license": "90097",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NM",
            "license": "TM2015-0763",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "74962",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Advanced Healthcare Technologies, Inc.
• Mohammad Ansari-Dezfuli
• Ahmad Ascha, MD
• Patricia Lucille Dicioccio, MA CCC/SLP
• Kara Lynn Dolling, MS, ATC, CSCS, PES
• Dr Michael Saalouke MD Inc
• Bridget Fiorello

• Neurology Physician in Gates Mills, OH
• Providers in Gates Mills, OH by specialty
• Neurology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.