Individual provider Active NPI

Jonathan W Sirkin, MD

  • Child & Adolescent Psychiatry Physician
  • Beachwood, OH
National Provider Identifier
1144345703
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
35081523 Issued in OH
Practice address
24200 Chagrin Blvd
The Office Place
Beachwood, OH 44122-5550
Phone
(216) 283-7690
Fax
(216) 766-6084
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 35081523 OH Primary

Addresses

Primary practice location

24200 Chagrin Blvd
The Office Place
Beachwood, OH 44122-5550

Mailing address

24200 Chagrin Blvd
The Office Place
Beachwood, OH 44122-5550
Phone (216) 283-7690

Other identifiers 1

IdentifierTypeStateIssuer
0150170MedicaidOH

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
I20041219000009 OH Practitioner - Psychiatry 4981661188 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35081523OHMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Ohio Office of Budget and Management State Accounting CurrentSince May 13, 2015 Accepting new patients
State of Ohio Office of Budget and Management State Accounting CurrentSince May 13, 2015 Accepting new patients
State of Ohio Office of Budget and Management State Accounting Current Accepting new patients
North East Ohio Health Services Past Accepting new patients

Locations

30 E Broad St
Fl 11
Columbus, OH 43215
Phone (614) 466-9930

1756 Sagamore Rd
Northfield, OH 44067
Phone (330) 467-7131

930 S Detroit Ave
Toledo, OH 43614
Phone (419) 381-1881

Interoperability endpoints

  • Direct secure messaging: jsirkin35344@mhas.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144345703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24200 CHAGRIN BLVD",
            "address_2": "THE OFFICE PLACE",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225550",
            "telephone_number": "216-283-7690",
            "fax_number": "216-766-6084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24200 CHAGRIN BLVD",
            "address_2": "THE OFFICE PLACE",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225550",
            "telephone_number": "216-283-7690",
            "fax_number": "216-766-6084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRKIN",
        "first_name": "JONATHAN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OH",
            "license": "35081523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0150170",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.