Individual provider Active NPI

Leanne M Chrisman-Khawam, MD

  • Family Medicine Physician
  • Cleveland, OH
National Provider Identifier
1144253337
Registry record updated Nov 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-079505 Issued in OH
Practice address
2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone
(216) 778-1054
Fax
(216) 778-8225
NPI assigned
Jul 9, 2006
Last updated
Nov 1, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35-079505 OH Primary

Addresses

Primary practice location

2500 Metrohealth Dr
Cleveland, OH 44109-1900

Mailing address

2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone (216) 778-1054

Other identifiers 6

IdentifierTypeStateIssuer
363425OtherOHWELLCARE
000000504065OtherOHANTHEM
2300594MedicaidOH
734337OtherOHBUCKEYE
7229295OtherOHAETNA
P00908722OtherOHMEDICARE RAILROAD

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
I20050525000064 OH Practitioner - Family Practice 7012959570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oregon Health Sciences University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Metrohealth SystemGroup PAC ID 8628982949, 1,150 clinicians

Practice addresses (Care Compare)

2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone (216) 778-7800

38 Main St
Suite 300
Westlake, OH 44145-5922
Phone (216) 957-3200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-079505OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System Family Medicine CurrentSince Aug 3, 2011 Accepting new patients
The Metrohealth System Current Accepting new patients
The Metrohealth System CurrentSince Aug 3, 2011 Accepting new patients
Licking Memorial Professional Corporation Past Accepting new patients
University Family Medicine Association Family Medicine Past Accepting new patients

Locations

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

4229 Pearl Rd
Cleveland, OH 44109
Phone (216) 459-6300

11100 Euclid Ave
Cleveland Heights, OH 44106

20575 Center Ridge Rd
Ste 500
Rocky River, OH 44116
Phone (216) 957-3200

Interoperability endpoints

  • Direct secure messaging: lchrismankhawam46873@direct.metrohealth.org

Organizations & group practices 5

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 2

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351728000000",
    "number": "1144253337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091900",
            "telephone_number": "216-778-1054",
            "fax_number": "216-778-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091900",
            "telephone_number": "216-778-1054",
            "fax_number": "216-778-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISMAN-KHAWAM",
        "first_name": "LEANNE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2012-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-079505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "363425",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000504065",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2300594",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEYE",
            "identifier": "734337",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7229295",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00908722",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.