Individual provider Active NPI

Colleen M Debarr, DPM

  • Podiatrist
  • Lorain, OH
National Provider Identifier
1104800515
Registry record updated Jul 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36.003563 Issued in OH
Practice address
5172 Leavitt Rd
Lorain, OH 44035
Phone
(440) 282-7420
Fax
(440) 282-9855
NPI assigned
Nov 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 000629 GA
Podiatrist 213E00000X 36.003563 OH Primary

Addresses

Primary practice location

5172 Leavitt Rd
Lorain, OH 44035

Mailing address

5334 Meadow Lane Court
Sheffield Village, OH 44035-1469
Phone (440) 934-5454

Other identifiers 1

IdentifierTypeStateIssuer
000493314AMedicaidGA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120802000642 OH Practitioner - PodiatryPractitioner - Orthopedic Surgery 6002813847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PodiatryAlso: Orthopedic Surgery
Education
California School of Podiatric Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

5172 Leavitt Rd
Lorain, OH 44053-2384

5172 N Leavitt Rd
Lorain, OH 44053-2384
Phone (440) 282-7420

5334 Meador Lane CT
Sheffield Village, OH 44035-1469

5800 Cooper Foster Park Rd W
Lorain, OH 44053-4131
Phone (216) 444-2200

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

Hospital & facility affiliations

  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue42
Removal of skin lesions1-10
Removal of nail tissue286
Removal or shaving of skin growth58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000629GAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Sep 23, 2014 Accepting new patients
A. Louis Jimenez, DPM, PC Foot & Ankle Surgery Past Accepting new patients
Gwinnett Podiatry Associates LLC Foot & Ankle Surgery PastSince Mar 1, 2008 Accepting new patients

Locations

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

5172 Leavitt Rd
Lorain, OH 44053
Phone (440) 282-7420

5334 Meadow Lane Ct
Sheffield Village, OH 44035
Phone (440) 934-5454

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343692800000",
    "number": "1104800515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5334 MEADOW LANE COURT",
            "city": "SHEFFIELD VILLAGE",
            "state": "OH",
            "postal_code": "440351469",
            "telephone_number": "440-934-5454",
            "fax_number": "440-934-8979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5172 LEAVITT RD",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "44035",
            "telephone_number": "440-282-7420",
            "fax_number": "440-282-9855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBARR",
        "first_name": "COLLEEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2012-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "000629",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36.003563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000493314A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorain, OH

Sources for this page

Verify at the official NPI Registry.