NPIMap

Individual provider Active NPI

Brian Joseph Juriga, DO

  • Sports Medicine (Family Medicine) Physician
  • Willowick, OH
National Provider Identifier
1245290204
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
34-008540 Issued in OH
Practice address
29804 Lakeshore Blvd.
Willowick, OH 44095
Phone
(440) 833-2010
Fax
(440) 833-2096
NPI assigned
Mar 24, 2006
Last updated
Feb 25, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 34-008540 OH Primary

Addresses

Primary practice location

29804 Lakeshore Blvd.
Willowick, OH 44095

Mailing address

29804 Lake Shore Blvd
Willowick, OH 44095-4611
Phone (440) 833-2010

Other identifiers 5

IdentifierTypeStateIssuer
264200000OtherOHFEDERAL BLACK LUNG
341425870042OtherOHMEDICAL MUTUAL OF OHIO
6600162OtherOHUNITED HEALTHCARE
264200000OtherOHDEPT OF LABOR
000000385887OtherOHANTHEM

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brian.juriga@lhpg.eclinicaldirect.com Direct

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
I20060124000459 OH Practitioner - Family Practice 8628092038 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

158 W Main Rd
Conneaut, OH 44030-2039

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34-008540OHMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc Current Accepting new patients
Lake Hospital System CurrentSince Feb 1, 2009 Accepting new patients
University Primary Care Practices Inc CurrentSince Apr 6, 2025 Accepting new patients
Lake Hospital System Inc Current Accepting new patients
University Primary Care Practices Inc CurrentSince Apr 6, 2025 Accepting new patients
Lake Hospital System Inc. Past Accepting new patients
Lake Hospital System, Inc Past Accepting new patients
Clark Weeks PC Past Accepting new patients
Lake Hospital System Past Accepting new patients
Lake Hospital System Inc Past Accepting new patients
Lake Hospital System Inc. Past Accepting new patients

Locations

510 5th Ave
Chardon, OH 44024
Phone (440) 285-9494

7590 Auburn Rd
Ste 14
Concord Township, OH 44077
Phone (440) 354-1899

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

6270 N Ridge Rd
Madison, OH 44057
Phone (440) 428-8292

8655 Market St
Mentor, OH 44060
Phone (440) 255-6400

7956 Tyler Blvd
Mentor on Lk, OH 44060
Phone (440) 255-4455

29804 Lake Shore Blvd
Willowick, OH 44095
Phone (440) 585-3322

Interoperability endpoints

  • Direct secure messaging: bjuriga37612@ehrdirect.uhhospitals.org

Organizations & group practices 11

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1245290204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29804 LAKE SHORE BLVD",
            "city": "WILLOWICK",
            "state": "OH",
            "postal_code": "440954611",
            "telephone_number": "440-833-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29804 LAKESHORE BLVD.",
            "city": "WILLOWICK",
            "state": "OH",
            "postal_code": "44095",
            "telephone_number": "440-833-2010",
            "fax_number": "440-833-2096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURIGA",
        "first_name": "BRIAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "OH",
            "license": "34-008540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "264200000",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL OF OHIO",
            "identifier": "341425870042",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "6600162",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "264200000",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000385887",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brian.juriga@lhpg.eclinicaldirect.com",
            "affiliation": "N",
            "endpointDescription": "Baseline West Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "8655 Market Street",
            "city": "Mentor",
            "state": "OH",
            "country_code": "US",
            "postal_code": "44060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Willowick, OH

Sources for this page

Verify at the official NPI Registry.