Organization Active NPI

Joel D. Weisblat, M.D., Inc.

  • Primary Care Clinic/Center
  • Beachwood, OH
National Provider Identifier
1164477477
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
35-064937 Issued in OH
Legal business name
JOEL D. WEISBLAT, M.D., INC.
Practice address
23250 Mercantile Rd Ste 140
Beachwood, OH 44122-5928
Phone
(216) 464-4646
Fax
(216) 464-4695
NPI assigned
May 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Authorized official

Name
Dr. Joel David Weisblat, M.D.NPI 1437198264
Title
President
Phone
(216) 464-4646

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 35-064937 OH Primary

Addresses

Primary practice location

23250 Mercantile Rd Ste 140
Beachwood, OH 44122-5928

Mailing address

23250 Mercantile Rd Ste 140
Beachwood, OH 44122-5928
Phone (216) 464-4646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040709000600 OH Part B Supplier - Clinic/Group Practice 6507844206 Receives reassigned benefits from 3 practitioners
Practice locations: Beachwood, OH
O20251204003121 NY Part B Supplier - Clinic/Group Practice 6507844206 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

244 5th Ave
Ste G264
New York, NY 10001
Phone (216) 464-4696

23250 Mercantile Rd
Ste 140
Beachwood, OH 44122
Phone (216) 464-4646

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11849/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1164477477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23250 MERCANTILE RD STE 140",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225928",
            "telephone_number": "216-464-4646",
            "fax_number": "216-464-4695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23250 MERCANTILE RD STE 140",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225928",
            "telephone_number": "216-464-4646",
            "fax_number": "216-464-4695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOEL D. WEISBLAT, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2024-07-15",
        "certification_date": "2024-06-27",
        "status": "A",
        "authorized_official_last_name": "WEISBLAT",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-464-4646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OH",
            "license": "35-064937",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.