Individual provider Active NPI

Gasan Nemr, MD

  • Internal Medicine Physician
  • Lakewood, OH
National Provider Identifier
1205803665
Registry record updated Jul 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35082501N Issued in OH
Practice address
15000 Madison Ave
Lakewood, OH 44107
Phone
(216) 221-7642
Fax
(216) 529-7806
NPI assigned
Mar 3, 2006
Last updated
Jul 11, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35082501N OH Primary

Addresses

Primary practice location

15000 Madison Ave
Lakewood, OH 44107

Mailing address

24651 Center Ridge Rd
Ste 350
Westlake, OH 44145-5627
Phone (440) 895-5056

Other identifiers 10

IdentifierTypeStateIssuer
11059884OtherCAQH
0119204OtherGROUP MEDICAID
3610861OtherGROUP ASC MEDICARE
9273172OtherGROUP MEDICARE
D368301OtherGROUP IND DIAGNOSTICS MED
1780634279OtherGROUP NPI
P00035659OtherRR MEDICARE INDIVIDUAL
103872OtherKAISER
2422373MedicaidOH
CA4511OtherRR MEDICARE GROUP

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
I20031208000291 OH Practitioner - Internal Medicine 1557267051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Premier Physicians Centers IncGroup PAC ID 0345153326, 50 clinicians

Practice addresses (Care Compare)

25200 Ctr Ridge Rd
Westlake, OH 44145-4142

25200 Ctr Ridge Rd
Suite 2300
Westlake, OH 44145-4148
Phone (440) 331-5053

25200 Ctr Ridge Rd
Suite 2400
Westlake, OH 44145-4152
Phone (440) 333-3332

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35082501NOHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Physicians Centers Inc CurrentSince Jan 1, 2004 Accepting new patients
Premier Physicians Centers, Inc. Internal Medicine CurrentSince Jan 1, 2004 Accepting new patients
North East Ohio Group Practice LLC Internal Medicine Past Accepting new patients
Fairview Hospital Past Accepting new patients
Premier Physicians Centers, Inc Past Accepting new patients
Nivalis Health LLC PastSince Aug 30, 2017 Accepting new patients

Locations

12409 Lorain Ave
Ste 100
Cleveland, OH 44111
Phone (216) 251-9066

15000 Madison Ave
Lakewood, OH 44107
Phone (216) 221-7642

21851 Center Ridge Rd
Ste 107
Rocky River, OH 44116
Phone (216) 221-7642

24500 Center Ridge Rd
Ste 375
Westlake, OH 44145
Phone (440) 467-1954

24651 Center Ridge Rd
Ste 350
Westlake, OH 44145
Phone (440) 328-4949

25200 Center Ridge Rd
Ste 2300
Westlake, OH 44145
Phone (440) 331-5053

29000 Center Ridge Rd
Westlake, OH 44145
Phone (440) 414-6046

29325 Health Campus Dr
Ste 1
Westlake, OH 44145
Phone (440) 835-6996

Interoperability endpoints

  • Direct secure messaging: gasan.nemr@ppc2.eclinicaldirectplus.com
  • Direct secure messaging: gnemr35853@ehrdirect.uhhospitals.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Nivalis Health LLCWestlake, OH, CCN 361705 Hospice Contracted Managing Employee Aug 30, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1205803665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24651 CENTER RIDGE RD",
            "address_2": "STE 350",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455627",
            "telephone_number": "440-895-5056",
            "fax_number": "440-333-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15000 MADISON AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "44107",
            "telephone_number": "216-221-7642",
            "fax_number": "216-529-7806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEMR",
        "first_name": "GASAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35082501N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11059884",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID",
            "identifier": "0119204",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP ASC MEDICARE",
            "identifier": "3610861",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "9273172",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP IND DIAGNOSTICS MED",
            "identifier": "D368301",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1780634279",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE INDIVIDUAL",
            "identifier": "P00035659",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "103872",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2422373",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "CA4511",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, OH

Sources for this page

Verify at the official NPI Registry.