Active NPI
Cleveland Breast Clinic
- Surgical Oncology Physician
- Cleveland, OH
National Provider Identifier
1215155015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Oncology Physician
- Legal business name
- CLEVELAND BREAST CLINIC
- Practice address
- 18660 Bagley Rd
Ste. 305 BLDG. 2
Cleveland, OH 44130-3483 - Phone
- (440) 234-9338
- Fax
- (440) 234-1448
- NPI assigned
- Apr 24, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ahmad H. Shatila, M.D.
- Title
- Physician Owner
- Phone
- (440) 234-9338
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Oncology Physician | 2086X0206X | OH | Primary |
Addresses
Primary practice location
18660 Bagley Rd
Ste. 305 BLDG. 2
Cleveland, OH 44130-3483
Mailing address
18660 Bagley Rd
Ste. 305 BLDG. 2
Cleveland, OH 44130-3483
Phone (440) 234-9338
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000006129197 | Other | OH | BLUE CROSS |
| 1500454 | Other | OH | UMWA |
National Provider Directory
National Provider DirectoryLocations
18660 Bagley Rd
#305
Cleveland, OH 44130
Phone (440) 234-2988
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1215155015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18660 BAGLEY RD",
"address_2": "STE. 305 BLDG. 2",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441303483",
"telephone_number": "440-234-9338",
"fax_number": "440-234-1448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18660 BAGLEY RD",
"address_2": "STE. 305 BLDG. 2",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441303483",
"telephone_number": "440-234-9338",
"fax_number": "440-234-1448"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLEVELAND BREAST CLINIC",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-24",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "SHATILA",
"authorized_official_first_name": "AHMAD",
"authorized_official_middle_name": "H.",
"authorized_official_title_or_position": "PHYSICIAN OWNER",
"authorized_official_telephone_number": "440-234-9338",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "2086X0206X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery, Surgical Oncology",
"state": "OH",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "000006129197",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UMWA",
"identifier": "1500454",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
- Cleveland Arts & Social Sciences Academy
- Cleveland Arts and Wellness Center
- Cleveland Autism Treatment Specialists
- Cleveland Back & Pain Management Center Inc.
- Cleveland Biologicals Inc.
- Cleveland Center for Family Dentistry Inc
- Cleveland Center for Joint Reconstruction, Inc
- Cleveland Christian Home
- Cleveland Christian Home
- Cleveland Christian Hospice Care
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.