Individual provider Active NPI

Adam Warren Jr., D.P.M

  • Foot Surgery Podiatrist
  • Shaker HTS, OH
National Provider Identifier
1326170358
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
2253 Issued in OH
Practice address
3645 Warrensville Center Rd
Suite 314
Shaker HTS, OH 44122-5247
Phone
(216) 752-7700
Fax
(216) 752-7720
NPI assigned
Mar 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 2253 OH Primary

Addresses

Primary practice location

3645 Warrensville Center Rd
Suite 314
Shaker HTS, OH 44122-5247

Mailing address

3645 Warrensville Center Rd
Suite 314
Shaker HTS, OH 44122-5247
Phone (216) 752-7700

Other identifiers 1

IdentifierTypeStateIssuer
0560718MedicaidOH

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20101014000060 OH Practitioner - Podiatry 9234321852 Reassigns benefits to 1 organization
Practice locations: Lyndhurst, OH

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5001 Mayfield Rd
Suite 115 10
Lyndhurst, OH 44124-2602
Phone (216) 752-7700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue223

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2253OHMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
State of Ohio Office of Budget and Management State Accounting CurrentSince Jun 11, 2020 Accepting new patients
State of Ohio Office of Budget and Management State Accounting CurrentSince Jun 11, 2020 Accepting new patients
State of Ohio Office of Budget and Management State Accounting Current Accepting new patients

Locations

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

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

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

Organizations & group practices 3

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 1

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": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326170358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3645 WARRENSVILLE CENTER RD",
            "address_2": "SUITE 314",
            "city": "SHAKER HTS",
            "state": "OH",
            "postal_code": "441225247",
            "telephone_number": "216-752-7700",
            "fax_number": "216-752-7720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3645 WARRENSVILLE CENTER RD",
            "address_2": "SUITE 314",
            "city": "SHAKER HTS",
            "state": "OH",
            "postal_code": "441225247",
            "telephone_number": "216-752-7700",
            "fax_number": "216-752-7720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "ADAM",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.P.M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "OH",
            "license": "2253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0560718",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shaker HTS, OH

Sources for this page

Verify at the official NPI Registry.