Brian Andrew Koludrovich, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

36002432 Issued in OH

Practice address

35010 Chardon Rd Ste 101a
Willoughby Hills, OH 44094-9011

Phone

(440) 953-3668

Fax

(440) 953-3556

NPI assigned

Nov 13, 2006

Last updated

May 7, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Eastern Ohio Podiatry Group LLCGroup PAC ID 3072771336, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marymount Hospital Hospital, Garfield Heights, OH, CCN 360143

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

88.16

Promoting interoperability

99

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bkoludrovichdpm32644@direct.ccf.org

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.

• North Eastern Ohio Podiatry Group LLC

  • Foot & Ankle Surgery Podiatrist
  • Willoughby Hills, OH
  • NPI 1447529656
  Medicare reassignment Care Compare group NPD
• Euclid Hospital Cleveland Clinic Health System

  dba cleveland clinic foundation

  • General Acute Care Hospital
  • Euclid, OH
  • NPI 1457403016
  NPD
• North Eastern Ohio Podiatry Group LLC

  • Foot & Ankle Surgery Podiatrist
  • Beachwood, OH
  • NPI 1073260832
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Marymount Hospital Inc

  dba Marymount Hospital

  • General Acute Care Hospital
  • Garfield Heights, OH
  • NPI 1942248737
  Care Compare affiliation

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1295806248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35010 CHARDON RD STE 101A",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440949011",
            "telephone_number": "440-953-3668",
            "fax_number": "440-953-3556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35010 CHARDON RD STE 101A",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440949011",
            "telephone_number": "440-953-3668",
            "fax_number": "440-953-3556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24755 Chagrin Blvd",
            "address_2": "Suite 135",
            "address_purpose": "LOCATION",
            "city": "Beachwood",
            "state": "OH",
            "postal_code": "441225682",
            "country_code": "US",
            "telephone_number": "440-953-3668",
            "fax_number": "440-953-3556",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "99 Northline Cir Ste 200",
            "address_purpose": "LOCATION",
            "city": "Euclid",
            "state": "OH",
            "postal_code": "441191481",
            "country_code": "US",
            "telephone_number": "440-953-3668",
            "fax_number": "440-953-3556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLUDROVICH",
        "first_name": "BRIAN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36002432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0752270",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Kightlinger
• Jamica King
• Mia Isabella King
• Samantha Kissig
• Ashley Michelle Knight
• Michael Paul Koniarczyk, M.D.
• Brandon George Kopfstein, DPT
• Matthew Gerard Kramer
• Gina Ivana Kucmanic, RD
• L&P Enterprises, Inc (Great Lakes Chiropractic & Nutrition Center)

• Podiatrist in Willoughby Hills, OH
• Providers in Willoughby Hills, OH by specialty
• Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.