Active NPI
Jordan Atanasov Kazakov, MD
- Pulmonary Disease Physician
- Cleveland, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- FK4226595
- Practice address
- 11100 Euclid Ave # Bolwell 6
Cleveland, OH 44106-1716 - Phone
- (216) 844-1722
- NPI assigned
- Dec 6, 2010
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 330879 | LA | |
| Pulmonary Disease Physician | 207RP1001X | FK4226595 | OH | Primary |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 330879 | LA | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | FK4226595 | OH | |
| Pulmonary Disease Physician | 207RP1001X | 330879 | LA |
Addresses
Primary practice location
11100 Euclid Ave # Bolwell 6
Cleveland, OH 44106-1716
Mailing address
1401 Prospect Ave E Apt 805
Cleveland, OH 44115-2349
Phone (843) 902-7253
Other practice location 1
2647 S Saint Elizabeth Blvd Ste 215
Gonzales, LA 70737-5020
Phone (225) 765-5500
Other practice location 2
309 Jackson St
Monroe, LA 71201-7407
Phone (318) 966-4541
Other practice location 3
7777 Hennessy Blvd Ste 701
Baton Rouge, LA 70808-4370
Phone (225) 765-5864
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jkazakov2493750@direct.casso.us.com | Direct | |
| FHIR URL | https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI, IL, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Critical Care (Intensivists)
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 E 77TH St
New York, NY 10075-1850
Phone (212) 434-2140
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| FK4226595 | OH | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Dupage Physician Group | Current | Accepting new patients | |
| Prime Healthcare Services Landmark LLC | Current | Accepting new patients | |
| Prime Healthcare Services Landmark LLC | Current | Accepting new patients | |
| North Shore-Lij Medical PC | Hospitalist | Current | Accepting new patients |
| Central Dupage Physician Group | Hospitalist | Current | Accepting new patients |
| St Francis Medical Center, Inc | Past | Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Locations
Dept 5777
Carol Stream, IL 60122
10400 Haligus Rd
Huntley, IL 60142
Phone (224) 654-0000
4201 W Medical Center Dr
McHenry, IL 60050
Phone (815) 759-3100
1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045
1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650
100 E 77th St
New York, NY 10075
Phone (212) 434-2606
300 Community Dr
Plandome, NY 11030
115 Cass Ave
Woonsocket, RI 02895
Phone (401) 356-1701
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
Interoperability endpoints
- jkazakov2493750@direct.casso.us.com
- jkazakov29871@tuftsmedicine.direct-ci.com
- jkazakov65919@northwell.direct-ci.com
Organizations & group practices 7
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.
-
- Family Medicine Physician
- Carol Stream, IL
- NPI 1033149844
Hospitalist
-
- Hematology & Oncology Physician
- Woonsocket, RI
- NPI 1518388651
-
- Orthopaedic Surgery Physician
- Geneva, IL
- NPI 1780012344
-
- General Acute Care Hospital
- Woonsocket, RI
- NPI 1699752923
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
-
- Rehabilitation Hospital Unit
- Monroe, LA
- NPI 1013906239
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- New York, NY
- NPI 1477616571
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678752000000",
"number": "1144523630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 PROSPECT AVE E APT 805",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441152349",
"telephone_number": "843-902-7253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11100 EUCLID AVE # BOLWELL 6",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441061716",
"telephone_number": "216-844-1722"
}
],
"practiceLocations": [
{
"address_1": "2647 S Saint Elizabeth Blvd Ste 215",
"address_purpose": "LOCATION",
"city": "Gonzales",
"state": "LA",
"postal_code": "707375020",
"country_code": "US",
"telephone_number": "225-765-5500",
"fax_number": "225-644-4206",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "309 Jackson St",
"address_purpose": "LOCATION",
"city": "Monroe",
"state": "LA",
"postal_code": "712017407",
"country_code": "US",
"telephone_number": "318-966-4541",
"fax_number": "318-966-4543",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7777 Hennessy Blvd Ste 701",
"address_purpose": "LOCATION",
"city": "Baton Rouge",
"state": "LA",
"postal_code": "708084370",
"country_code": "US",
"telephone_number": "225-765-5864",
"fax_number": "225-765-2013",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KAZAKOV",
"first_name": "JORDAN",
"middle_name": "ATANASOV",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-12-06",
"last_updated": "2023-03-14",
"certification_date": "2023-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "LA",
"license": "330879",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "OH",
"license": "FK4226595",
"primary": true
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "LA",
"license": "330879",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "OH",
"license": "FK4226595",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "LA",
"license": "330879",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jkazakov2493750@direct.casso.us.com",
"affiliation": "N",
"endpointDescription": "FMOLHS-Epic",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "jkazakov2493750@direct.casso.us.com",
"address_1": "309 Jackson St",
"city": "Monroe",
"state": "LA",
"country_code": "US",
"postal_code": "712017407",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "FMOLHS FHIR URL",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "309 Jackson St",
"city": "Monroe",
"state": "LA",
"country_code": "US",
"postal_code": "712017407",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.