Individual provider Active NPI

Kelsey Nawal Bachir, PA-C

  • Physician Assistant
  • Euclid, OH
National Provider Identifier
1336797885
Registry record updated May 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.005858RX Issued in OH
Practice address
18901 Lake Shore Blvd
Euclid, OH 44119-1078
Phone
(216) 531-9000
NPI assigned
Aug 28, 2019
Last updated
May 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Physician Assistant 363A00000X 50.005858RX OH Primary

Addresses

Primary practice location

18901 Lake Shore Blvd
Euclid, OH 44119-1078

Mailing address

18901 Lake Shore Blvd
Euclid, OH 44119-1078

Other practice location 1

417 W Prospect Rd
Ashtabula, OH 44004-5862
Phone (440) 381-8520

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200217001538 OH Practitioner - Physician Assistant 5799112512 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

33100 Cleveland Clinic Blvd
Avon, OH 44011-1390
Phone (440) 695-4000

33300 Cleveland Clinic Blvd
Avon, OH 44011-1172
Phone (440) 695-5000

5700 Cooper Foster Park Rd W
Lorain, OH 44053-4152
Phone (440) 204-7400

5800 Cooper Foster Park Rd W
Lorain, OH 44053-4131
Phone (216) 444-2200

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

State licenses

LicenseStateTypeSpecialty
50.005858RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cleveland Clinic Health System - East Region CurrentSince Mar 13, 2020 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Jul 28, 2021 Accepting new patients

Locations

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

18901 Lake Shore Blvd
Euclid, OH 44119
Phone (216) 531-9000

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1336797885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18901 LAKE SHORE BLVD",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441191078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18901 LAKE SHORE BLVD",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441191078",
            "telephone_number": "216-531-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "417 W Prospect Rd",
            "address_purpose": "LOCATION",
            "city": "Ashtabula",
            "state": "OH",
            "postal_code": "440045862",
            "country_code": "US",
            "telephone_number": "440-381-8520",
            "fax_number": "440-381-8522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACHIR",
        "first_name": "KELSEY",
        "middle_name": "NAWAL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005858RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Euclid, OH

Sources for this page

Verify at the official NPI Registry.