Individual provider Active NPI

Azadeh Khosravi, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Beachwood, OH
National Provider Identifier
1245605658
Registry record updated Dec 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18069.NP Issued in OH
Practice address
3999 Richmond Rd
Beachwood, OH 44122-6046
Phone
(330) 766-2700
NPI assigned
Dec 10, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 18069.NP OH Primary

Addresses

Primary practice location

3999 Richmond Rd
Beachwood, OH 44122-6046

Mailing address

5590 Janet Blvd
Solon, OH 44139-1961
Phone (330) 766-2700

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160405000103 OH Practitioner - Nurse Practitioner 2466759501 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.19 of 100Reported as group
Quality
63.13
Promoting interoperability
100
Improvement activities
40
Cost
74.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
18069.NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Medical Group Inc CurrentSince Mar 1, 2016 Accepting new patients
University Hospitals Ahuja Medical Center CurrentSince Mar 1, 2016 Accepting new patients
University Hospitals Ahuja Medical Center CurrentSince Mar 1, 2016 Accepting new patients
University Hospitals Ahuja Medical Center, Inc Current Accepting new patients
Multicare Health System Past Accepting new patients

Locations

3999 Richmond Rd
Cleveland, OH 44122
Phone (216) 293-8226

11100 Euclid Ave
Cleveland Heights, OH 44106

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

20800 Harvard Rd
Fl 2
Highland Hills, OH 44122
Phone (216) 358-2156

Interoperability endpoints

  • Direct secure messaging: akhosravi27711@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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449705600000",
    "number": "1245605658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5590 JANET BLVD",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441391961",
            "telephone_number": "330-766-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3999 RICHMOND RD",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441226046",
            "telephone_number": "330-766-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOSRAVI",
        "first_name": "AZADEH",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-10",
        "last_updated": "2015-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "18069.NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.