NPIMap

Individual provider Active NPI

Stacey E. Jolly, MD

  • Internal Medicine Physician
  • Cleveland, OH
National Provider Identifier
1316064785
Registry record updated May 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35-093068 Issued in OH
Practice address
Cleveland Clinic
9500 Euclid Avenue/S-70
Cleveland, OH 44195-0001
Phone
(216) 444-8188
Fax
(216) 445-1076
NPI assigned
Mar 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A83820 CA
Internal Medicine Physician 207R00000X 35-093068 OH Primary

Addresses

Primary practice location

Cleveland Clinic
9500 Euclid Avenue/S-70
Cleveland, OH 44195-0001

Mailing address

Cleveland Clinic
9500 Euclid Avenue/S-70
Cleveland, OH 44195-0001
Phone (216) 444-8188

Other identifiers 1

IdentifierTypeStateIssuer
072207OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER

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
I20090601000000 OH Practitioner - Internal Medicine 8123094968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Stanford University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A83820CAMDInternal Medicine Physician
35-093068OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Apr 6, 2009 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

9500 Euclid Ave
#70
Cleveland, OH 44195
Phone (216) 444-8188

Interoperability endpoints

  • Direct secure messaging: sjollymd81762@direct.ccf.org

Organizations & group practices 2

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241136000000",
    "number": "1316064785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CLEVELAND CLINIC",
            "address_2": "9500 EUCLID AVENUE/S-70",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-444-8188",
            "fax_number": "216-445-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CLEVELAND CLINIC",
            "address_2": "9500 EUCLID AVENUE/S-70",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-444-8188",
            "fax_number": "216-445-1076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLY",
        "first_name": "STACEY",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2009-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A83820",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-093068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SFGH INTERNAL USE ONLY-COMMERCIAL NUMBER",
            "identifier": "072207",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.