Active NPI
Mourad El-Gazzar, MD
- Internal Medicine Physician
- Lakewood, OH
National Provider Identifier
1245206903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 35057954E
- Practice address
- 15000 Madison Ave
Lakewood, OH 44107 - Phone
- (216) 227-9964
- Fax
- (216) 221-5473
- NPI assigned
- Feb 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35057954E | OH | Primary |
Addresses
Primary practice location
15000 Madison Ave
Lakewood, OH 44107
Mailing address
20525 Center Ridge Rd
Ste 220
Rocky River, OH 44116
Phone (440) 895-5056
Other identifiers 15
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 108122 | Other | KAISER | |
| D368301 | Other | OH | DIAGNOSTIC MEDICARE GROUP |
| 3610861 | Other | OH | ASC MEDICARE GROUP |
| 10826651 | Other | CAQH | |
| 341783789089 | Other | CARESOURCE | |
| 5676539 | Other | OH | AETNA |
| CA4511 | Other | GROUP RR MEDICARE | |
| 110203792 | Other | OH | RAILROAD MEDICARE |
| 000000190833 | Other | ANTHEM | |
| 0947560 | Medicaid | OH | |
| 9273172 | Other | OH | MEDICARE GROUP |
| 108122 | Other | OH | KAISER |
| 1780634279 | Other | GROUP NPI | |
| L57954 | Other | SUMMACARE APEX | |
| 9273172 | Other | GROUP MEDICAID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35057954E | OH | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Physicians Centers, Inc | Past | Accepting new patients | |
| Lakewood Hospital Association | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Lakewood, OH
- NPI 1205933512
Internal Medicine
-
- Clinical Medical Laboratory
- Westlake, OH
- NPI 1396928883
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405987200000",
"number": "1245206903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20525 CENTER RIDGE RD",
"address_2": "STE 220",
"city": "ROCKY RIVER",
"state": "OH",
"postal_code": "44116",
"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": "216-227-9964",
"fax_number": "216-221-5473"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EL-GAZZAR",
"first_name": "MOURAD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-23",
"last_updated": "2014-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "35057954E",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER",
"identifier": "108122",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DIAGNOSTIC MEDICARE GROUP",
"identifier": "D368301",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASC MEDICARE GROUP",
"identifier": "3610861",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "10826651",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARESOURCE",
"identifier": "341783789089",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5676539",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP RR MEDICARE",
"identifier": "CA4511",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110203792",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000190833",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0947560",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "9273172",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER",
"identifier": "108122",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1780634279",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUMMACARE APEX",
"identifier": "L57954",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICAID",
"identifier": "9273172",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.