Individual provider Active NPI

Benjamin Leonard Fortson, M.D.

  • Pediatric Radiology Physician
  • Cleveland, OH
National Provider Identifier
1063945756
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
35.145137 Issued in OH
Practice address
9500 Euclid Ave
Cleveland, OH 44195-0001
Phone
(216) 444-2200
NPI assigned
Apr 10, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X 35.145137 OH Primary

Addresses

Primary practice location

9500 Euclid Ave
Cleveland, OH 44195-0001

Mailing address

9500 Euclid Ave
Cleveland, OH 44195-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230731000893 OH Practitioner - Diagnostic Radiology 8820486772 Reassigns benefits to 3 organizations
I20240219003677 LA Practitioner - Diagnostic Radiology 8820486772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Washington School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Children'S Hospital 35 clinicians
Cleveland Clinic 6,954 clinicians

Practice addresses (Care Compare)

200 Henry Clay Ave
New Orleans, LA 70118-5720
Phone (504) 899-9511

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-5433

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinic Medical Services Company CurrentSince Aug 14, 2023 Accepting new patients
Children'S Hospital CurrentSince Dec 22, 2023 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Jul 12, 2023 Accepting new patients
Clinic Medical Services Company LLC Pediatric Radiology CurrentSince Aug 14, 2023 Accepting new patients
Children'S Hospital Pediatric Radiology CurrentSince Dec 22, 2023 Accepting new patients
Wooster Clinic, LLC CurrentSince Jul 12, 2023 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

4545 Veterans Memorial Blvd
Metairie, LA 70006
Phone (504) 896-9822

200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

6100 W Creek Rd
Ste 35
Independence, OH 44131
Phone (212) 986-1666

1740 Cleveland Rd
Wooster, OH 44691
Phone (330) 287-4500

Organizations & group practices 21

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1063945756",
    "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": "441950001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-444-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTSON",
        "first_name": "BENJAMIN",
        "middle_name": "LEONARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-10",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "OH",
            "license": "35.145137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.