Organization Active NPI

Broadview Heights Family Medicine, Inc

  • Family Medicine Physician
  • Broadview HTS, OH
National Provider Identifier
1063495224
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BROADVIEW HEIGHTS FAMILY MEDICINE, INC
Practice address
8075 Town Centre Dr Ste E
Broadview HTS, OH 44147-4011
Phone
(440) 717-6100
Fax
(440) 546-1382
NPI assigned
Nov 22, 2005
Last updated
Sep 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Authorized official

Name
Dr. Mark A Lang, MD
Title
Owner
Phone
(440) 717-6100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

8075 Town Centre Dr Ste E
Broadview HTS, OH 44147-4011

Mailing address

2001 E Royalton Rd
Broadview HTS, OH 44147-2811
Phone (440) 717-6100

Other identifiers 1

IdentifierTypeStateIssuer
2234764MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041222000470 OH Part B Supplier - Clinic/Group Practice 2567420508 Receives reassigned benefits from 6 practitioners
Practice locations: Broadview Heights, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0952647Broadview Heights Family Medicine, Inc8075 Town Centre Dr., Suite E, Broadview Heights, OH 44147Provider-performed microscopyOct 18, 2026

National Provider Directory

National Provider Directory

Locations

2001 E Royalton Rd
Ste C
Broadview Heights, OH 44147
Phone (440) 717-6100

8075 Town Centre Dr
Ste E
Broadview Hts, OH 44147
Phone (440) 717-6100

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758672000000",
    "number": "1063495224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 E ROYALTON RD",
            "city": "BROADVIEW HTS",
            "state": "OH",
            "postal_code": "441472811",
            "telephone_number": "440-717-6100",
            "fax_number": "440-546-1382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8075 TOWN CENTRE DR STE E",
            "city": "BROADVIEW HTS",
            "state": "OH",
            "postal_code": "441474011",
            "telephone_number": "440-717-6100",
            "fax_number": "440-546-1382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADVIEW HEIGHTS FAMILY MEDICINE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-22",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A",
        "authorized_official_last_name": "LANG",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-717-6100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2234764",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broadview HTS, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.