Active NPI
North Eastern Ohio Podiatry Group LLC
- Foot & Ankle Surgery Podiatrist
- Euclid, OH
National Provider Identifier
1295079085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- Legal business name
- NORTH EASTERN OHIO PODIATRY GROUP LLC
- Practice address
- 99 Northline Circle
Suite #200
Euclid, OH 44119-1481 - Phone
- (440) 953-3668
- NPI assigned
- Nov 16, 2012
- 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
- Dr. Vadim Glukh, DPM
- Title
- Physician/Partner/Owner
- Phone
- (440) 953-3668
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | Primary |
Addresses
Primary practice location
99 Northline Circle
Suite #200
Euclid, OH 44119-1481
Mailing address
35010 Chardon Rd
Suite #101a
Willoughby Hills, OH 44094-9010
Phone (440) 953-3668
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20121227000136 | OH | DME Supplier - Physician - Podiatry | 3072771336 | Practice locations: Euclid, OH |
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Foot & Ankle Surgery Podiatrist
- Beachwood, OH
- NPI 1073260832
3072771336
-
- Foot & Ankle Surgery Podiatrist
- Willoughby Hills, OH
- NPI 1447529656
3072771336
National Provider Directory
National Provider Directory- Tax ID family
- North Eastern Ohio Podiatry
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Foot & Ankle Surgery Podiatrist
- Beachwood, OH
- NPI 1073260832
-
- Foot & Ankle Surgery Podiatrist
- Willoughby Hills, OH
- NPI 1447529656
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353024000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1689811200000",
"number": "1295079085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35010 CHARDON RD",
"address_2": "SUITE #101A",
"city": "WILLOUGHBY HILLS",
"state": "OH",
"postal_code": "440949010",
"telephone_number": "440-953-3668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 NORTHLINE CIRCLE",
"address_2": "SUITE #200",
"city": "EUCLID",
"state": "OH",
"postal_code": "441191481",
"telephone_number": "440-953-3668"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTH EASTERN OHIO PODIATRY GROUP LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-11-16",
"last_updated": "2023-07-20",
"certification_date": "2023-07-20",
"status": "A",
"authorized_official_last_name": "GLUKH",
"authorized_official_first_name": "VADIM",
"authorized_official_title_or_position": "PHYSICIAN/PARTNER/OWNER",
"authorized_official_telephone_number": "440-953-3668",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Euclid, OH
- Duc Nhat Nguyen
- Brandie Nichols
- Noble Academy-Cleveland, Inc.
- Kanena Norman
- Kie-Arra Shanae Norris
- Northeast Ohio Medical Services, LLC
- Northeast Ohio Neighborhood Health Services, Inc.
- Northeast Ohio Neighborhood Health Services, Inc.
- Northeast Oral & Maxillofacial Surgeons, Inc
- Northern Ohio Medical Specialists, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.