North Eastern Ohio Podiatry Group LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

NORTH EASTERN OHIO PODIATRY GROUP LLC

Practice address

25101 Chagrin Blvd Ste 190
Beachwood, OH 44122-5643

Phone

(440) 953-3668

Fax

(440) 953-3556

NPI assigned

Mar 2, 2022

Organization subpart

No

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

Authorized official

Name

Alla Glukh

Title

Practice Manager

Phone

(440) 953-3668

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• North Eastern Ohio Podiatry Group LLC

  • Foot & Ankle Surgery Podiatrist
  • Euclid, OH
  • NPI 1295079085

  3072771336

  Same PAC ID
• North Eastern Ohio Podiatry Group LLC

  • Foot & Ankle Surgery Podiatrist
  • Willoughby Hills, OH
  • NPI 1447529656

  3072771336

  Same PAC ID

Tax ID family

North Eastern Ohio Podiatry3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• North Eastern Ohio Podiatry Group LLC

  • Foot & Ankle Surgery Podiatrist
  • Euclid, OH
  • NPI 1295079085
  NPD tax ID
• North Eastern Ohio Podiatry Group LLC

  • Foot & Ankle Surgery Podiatrist
  • Willoughby Hills, OH
  • NPI 1447529656
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vadim Glukh, DPM

  • Foot & Ankle Surgery Podiatrist
  • Willoughby Hills, OH
  • NPI 1164406195
  NPD
• Brian Andrew Koludrovich, DPM

  • Podiatrist
  • Willoughby Hills, OH
  • NPI 1295806248
  NPD

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744675200000",
    "number": "1073260832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35010 CHARDON RD STE 101A",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440949011",
            "telephone_number": "440-953-3668",
            "fax_number": "440-953-3556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25101 CHAGRIN BLVD STE 190",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225643",
            "telephone_number": "440-953-3668",
            "fax_number": "440-953-3556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH EASTERN OHIO PODIATRY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-02",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A",
        "authorized_official_last_name": "GLUKH",
        "authorized_official_first_name": "ALLA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "440-953-3668"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Beachwood, OH
• Providers in Beachwood, OH by specialty
• Foot & Ankle Surgery Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.