NPIMap

Individual provider Active NPI

Basem Alsarraj, MD

  • Psychiatry Physician
  • Westlake, OH
National Provider Identifier
1124381942
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
01076411A Issued in IN
Practice address
902 Westpoint Pkwy Ste 902
Westlake, OH 44145-1534
Phone
(216) 844-2400
NPI assigned
Jun 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OH
Psychiatry Physician 2084P0800X 01076411A IN Primary

Addresses

Primary practice location

902 Westpoint Pkwy Ste 902
Westlake, OH 44145-1534

Mailing address

6920 Pointe Inverness Way Ste 200
Fort Wayne, IN 46804-7934
Phone (260) 479-3516

Other identifiers 1

IdentifierTypeStateIssuer
201354450MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160621000961 IN Practitioner - Psychiatry 3173820891 Reassigns benefits to 2 organizations
I20220228002387 OH Practitioner - Psychiatry 3173820891 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-5000
Phone (216) 844-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.19 of 100Reported as group
Quality
63.13
Promoting interoperability
100
Improvement activities
40
Cost
74.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01076411AINMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc Current Accepting new patients
St Joseph Medical Group Inc CurrentSince Jul 1, 2016 Accepting new patients
FWBH, LLC CurrentSince Apr 1, 2023 Accepting new patients
St Joseph Medical Group Inc Psychiatry CurrentSince Jul 1, 2016 Accepting new patients
University Hospitals Medical Group Inc CurrentSince Jul 1, 2023 Accepting new patients
University Primary Care Practices Inc CurrentSince Apr 1, 2022 Accepting new patients
University Primary Care Practices Inc CurrentSince Apr 1, 2022 Accepting new patients
Emh Regional Medical Center Past Accepting new patients

Locations

3955 W Washington Center Rd
#R
Fort Wayne, IN 46818

2700 Lafayette St
Fort Wayne, IN 46806
Phone (219) 745-5415

3955 W Washington Center Rd
Fort Wayne, IN 46818
Phone (260) 800-3601

800 Broadway
Ste 315
Fort Wayne, IN 46802
Phone (260) 422-7427

800 Broadway
Ste 204
Fort Wayne, IN 46802
Phone (260) 420-4884

11100 Euclid Ave
Ste 1500
Cleveland, OH 44106
Phone (216) 844-3936

11100 Euclid Ave
Cleveland Heights, OH 44106

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

Interoperability endpoints

  • Direct secure messaging: balsarraj218310@ehrdirect.uhhospitals.org

Organizations & group practices 8

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.

Hospital & facility affiliations 5

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": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1124381942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 POINTE INVERNESS WAY STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047934",
            "telephone_number": "260-479-3516",
            "fax_number": "260-479-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 WESTPOINT PKWY STE 902",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441451534",
            "telephone_number": "216-844-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALSARRAJ",
        "first_name": "BASEM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-18",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01076411A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201354450",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, OH

Sources for this page

Verify at the official NPI Registry.