NPIMap

Individual provider Active NPI

Maisarah Momen, M.D.

  • Psychiatry Physician
  • Solon, OH
National Provider Identifier
1164837530
Registry record updated Jan 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35.133117 Issued in OH
Practice address
6935 Woodlands LN
Solon, OH 44139-4664
Phone
(440) 498-4756
NPI assigned
Jun 24, 2014
Last updated
Jan 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 6787 GA
Psychiatry Physician 2084P0800X 35.133117 OH Primary

Addresses

Primary practice location

6935 Woodlands LN
Solon, OH 44139-4664

Mailing address

6935 Woodlands LN
Solon, OH 44139-4664
Phone (440) 498-4756

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190815003624 OH Practitioner - Psychiatry 1456641844 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1044 Belmont Ave
Youngstown, OH 44504-1006
Phone (330) 480-3655

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6787GAMDPsychiatry Physician
35.133117OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown, LLC Psychiatry Current Accepting new patients
Steward Medical Group Inc. CurrentSince Feb 16, 2020 Accepting new patients
M & M Health Care, Inc. Psychiatry CurrentSince Jul 15, 2019 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Steward Medical Group, Inc CurrentSince Feb 16, 2020 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC Psychiatry CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown LLC CurrentSince Feb 1, 2020 Accepting new patients
Steward Medical Group, Inc PastSince Jan 19, 2020 Accepting new patients
Mercy Health Youngstown LLC Past Accepting new patients
Steward Trumbull Memorial Hospital, Inc. Past Accepting new patients

Locations

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

1350 E Market St
Warren, OH 44483
Phone (330) 841-5969

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

8401 Market St
Youngstown, OH 44512
Phone (330) 729-2929

Interoperability endpoints

  • Direct secure messaging: mmomen669983@direct.bsmhealth.org

Organizations & group practices 10

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": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1164837530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6935 WOODLANDS LN",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441394664",
            "telephone_number": "440-498-4756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6935 WOODLANDS LN",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441394664",
            "telephone_number": "440-498-4756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMEN",
        "first_name": "MAISARAH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "6787",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35.133117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Solon, OH

Sources for this page

Verify at the official NPI Registry.