NPIMap

Individual provider Active NPI

Irina Korobkova, M.D.

  • Psychiatry Physician
  • Cleveland, OH
National Provider Identifier
1265645287
Registry record updated Jul 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
57.009379 Issued in OH
Practice address
11100 Euclid Ave
Cleveland, OH 44106
Phone
(215) 844-2400
Fax
(216) 844-1703
NPI assigned
May 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 57.009379 OH Primary

Addresses

Primary practice location

11100 Euclid Ave
Cleveland, OH 44106

Mailing address

24701 Euclid Ave
3Rd Floor
Euclid, OH 44117-1714

Other identifiers 2

IdentifierTypeStateIssuer
P00771655OtherOHMEDICARE RAILROAD
2980707MedicaidOH

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
I20091008000159 OH Practitioner - Psychiatry 1557407335 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of Ohio Office of Budget and Management State Accounting 109 clinicians

Practice addresses (Care Compare)

4325 Green Road Cottage
Suite 3
Highland Hills, OH 44128-4884
Phone 33046777132454

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57.009379OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Ohio Office of Budget and Management State Accounting CurrentSince Aug 24, 2015 Accepting new patients
State of Ohio Office of Budget and Management State Accounting Current Accepting new patients
State of Ohio Office of Budget and Management State Accounting CurrentSince Aug 24, 2015 Accepting new patients
University Hospitals Medical Group Inc CurrentSince Sep 1, 2009 Accepting new patients
State of Ohio Office of Budget and Management State Accounting Past Accepting new patients

Locations

11100 Euclid Ave
Cleveland Heights, OH 44106

30 E Broad St
Fl 11
Columbus, OH 43215
Phone (614) 466-9930

24701 Euclid Ave
Fl 3
Euclid, OH 44117
Phone (216) 383-6950

4325 Green Rd
#3
Highland Hills, OH 44128
Phone (330) 467-7131

3000 Erie St S
Massillon, OH 44646
Phone (330) 833-3135

1756 Sagamore Rd
Northfield, OH 44067
Phone (330) 467-7131

Interoperability endpoints

  • Direct secure messaging: ikorobkova23101@mhas.direct-ci.com

Organizations & group practices 9

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": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310688000000",
    "number": "1265645287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24701 EUCLID AVE",
            "address_2": "3RD FLOOR",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441171714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44106",
            "telephone_number": "215-844-2400",
            "fax_number": "216-844-1703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOROBKOVA",
        "first_name": "IRINA",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2011-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "57.009379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00771655",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2980707",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.