Individual provider Active NPI

Mousab I Tabbaa, MD

  • Gastroenterology Physician
  • Westlake, OH
National Provider Identifier
1184642050
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
35053272 Issued in OH
Practice address
850 Columbia Rd Ste 200
Westlake, OH 44145-7215
Phone
(440) 808-1212
Fax
(440) 808-2060
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 35053272 OH Primary

Addresses

Primary practice location

850 Columbia Rd Ste 200
Westlake, OH 44145-7215

Mailing address

850 Columbia Rd Ste 200
Westlake, OH 44145-7215
Phone (440) 808-1212

Other practice location 1

7580 Northcliff Ave Ste 1000
Brooklyn, OH 44144-3271
Phone (440) 808-1212

Other identifiers 2

IdentifierTypeStateIssuer
110039356OtherOHRAILROAD MEDICARE
0727637MedicaidOH

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
I20101129000199 OH Practitioner - Gastroenterology 8426944745 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Gastroenterology, Inc.Group PAC ID 3072409382, 24 clinicians

Practice addresses (Care Compare)

7580 Northcliff Ave
Suite 1000
Cleveland, OH 44144-3271
Phone (440) 808-1212

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy237
Upper gastrointestinal (GI) endoscopy for acid reflux231

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35053272OHMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Nov 23, 2010 Accepting new patients
North Shore Endoscopy Center Gastroenterology Current Accepting new patients
North Shore Gastroenterology, Inc. Gastroenterology CurrentSince May 1, 2003 Accepting new patients
North Shore Pathology LLC CurrentSince Jul 31, 2023 Accepting new patients
Govind K Mehta, M.D., Inc. Past Accepting new patients

Locations

7580 Northcliff Ave
Ste 1000
Cleveland, OH 44144

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

125 E Broad St
Ste 115
Elyria, OH 44035
Phone (440) 329-7345

1 Infinity Corporate Centre Dr
Ste 103
Garfield Heights, OH 44125

1 Infinity Corporate Centre Dr
Ste 130
Garfield Hts, OH 44125
Phone (216) 663-7064

850 Columbia Rd
Ste 200
Westlake, OH 44145

835 Sharon Dr
Ste 250
Westlake, OH 44145

Interoperability endpoints

  • Direct secure messaging: mtabbaa37552@ehrdirect.uhhospitals.org

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1184642050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 COLUMBIA RD STE 200",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441457215",
            "telephone_number": "440-808-1212",
            "fax_number": "440-808-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 COLUMBIA RD STE 200",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441457215",
            "telephone_number": "440-808-1212",
            "fax_number": "440-808-2060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7580 Northcliff Ave Ste 1000",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "OH",
            "postal_code": "441443271",
            "country_code": "US",
            "telephone_number": "440-808-1212",
            "fax_number": "440-808-2060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TABBAA",
        "first_name": "MOUSAB",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "35053272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110039356",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0727637",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, OH

Sources for this page

Verify at the official NPI Registry.