Mohamed Bashar Mamlouk, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

35-038540 Issued in OH

Practice address

20455 Lorain Rd Ste 104B
Fairview Park, OH 44126-3529

Phone

(440) 356-2715

Fax

(440) 356-6978

NPI assigned

Mar 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 7

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mmamlouk32656@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 and National Provider Directory roles.

• Euclid Hospital Cleveland Clinic Health System

  • General Acute Care Hospital
  • Euclid, OH
  • NPI 1457403016
  NPD
• Premier Physicians Centers Inc

  • Durable Medical Equipment & Medical Supplies
  • Westlake, OH
  • NPI 1679201479
  NPD (past)

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423785600000",
    "number": "1306805304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30701 LORAIN RD STE A",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440706325",
            "telephone_number": "440-274-5035",
            "fax_number": "440-716-8608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20455 LORAIN RD STE 104B",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441263529",
            "telephone_number": "440-356-2715",
            "fax_number": "440-356-6978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMLOUK",
        "first_name": "MOHAMED",
        "middle_name": "BASHAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2015-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35-038540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0366698",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "264168",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000130207",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2597481",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUMMACARE",
            "identifier": "341313510BM",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "18958",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4007588",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• M Bashar Mamlouk MD Inc
• Colleen Mackay, M.S., CCC-SLP
• Edward John Magiste, PH.D., LISW-S
• Cassandre Dee Majewski, LMT
• Rebecca Malek, OTR/L
• Thaddeus Jude John Mandato, D.D.S.
• Michaela S Mansfield
• Christine Marcinowski, PT
• Mark J Pompeani DDS Inc
• Mason Martin, D.C.

• Cardiovascular Disease Physician in Fairview Park, OH
• Providers in Fairview Park, OH by specialty
• Cardiovascular Disease Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.