Active NPI
Jonathan W Sirkin, MD
- Child & Adolescent Psychiatry Physician
- Beachwood, OH
National Provider Identifier
1144345703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 35081523
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0150170 | Medicaid | OH |
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
Enrollment records 1
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.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35081523 | OH | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Ohio Office of Budget and Management State Accounting | Current | Accepting new patients | |
| State of Ohio Office of Budget and Management State Accounting | Current | 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
- 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.
-
- Psychiatric Hospital
- Cincinnati, OH
- NPI 1023082716
-
- Psychiatric Hospital
- Toledo, OH
- NPI 1083688097
-
- Nursing Facility/Intermediate Care Facility
- Sandusky, OH
- NPI 1790732576
-
- Community/Behavioral Health Agency
- Beachwood, OH
- NPI 1770671562
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.