Individual provider Active NPI

Maher Azzouz, MD

  • Gastroenterology Physician
  • Westlake, OH
National Provider Identifier
1336160498
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
35 091016 Issued in OH
Practice address
850 Columbia Rd
Suite 200
Westlake, OH 44145-1493
Phone
(440) 808-1212
Fax
(440) 808-0321
NPI assigned
Jul 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD057500L PA
Hepatology Physician 207RI0008X 35 091016 OH
Gastroenterology Physician 207RG0100X 35 091016 OH Primary

Addresses

Primary practice location

850 Columbia Rd
Suite 200
Westlake, OH 44145-1493

Mailing address

1622 E Market St
Warren, OH 44483-6613
Phone (330) 399-7215

Other identifiers 1

IdentifierTypeStateIssuer
2847932MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080318000408 OH Practitioner - GastroenterologyPractitioner - Other (Physician) 4880770791 Reassigns benefits to 1 organization
I20211006001348 PA Practitioner - Gastroenterology 4880770791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Gastroenterology Clinic and Endoscopy Center IncGroup PAC ID 3274429477, 36 clinicians

Practice addresses (Care Compare)

1622 E Market St
Warren, OH 44483-6613
Phone (330) 399-7215

949 N Hermitage Rd
Hermitage Gastroenterology Group Inc
Hermitage, PA 16148-3219
Phone (330) 399-7215

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy70
Upper gastrointestinal (GI) endoscopy for acid reflux95

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD057500LPAMDGastroenterology Physician
35 091016OHMDHepatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Gastroenterology Clinic & Endoscopy Center Inc Gastroenterology CurrentSince Jun 1, 2021 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
North Shore Endoscopy Center Gastroenterology Past Accepting new patients

Locations

1622 E Market St
Warren, OH 44483
Phone (330) 399-7215

949 N Hermitage Rd
Hermitage, PA 16148
Phone (330) 399-7215

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 4

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": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1336160498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1622 E MARKET ST",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444836613",
            "telephone_number": "330-399-7215",
            "fax_number": "330-399-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 COLUMBIA RD",
            "address_2": "SUITE 200",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441451493",
            "telephone_number": "440-808-1212",
            "fax_number": "440-808-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZZOUZ",
        "first_name": "MAHER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD057500L",
            "primary": false
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hepatology",
            "state": "OH",
            "license": "35 091016",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "35 091016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2847932",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, OH

Sources for this page

Verify at the official NPI Registry.