Active NPI
Northeast Psychiatry Associates LLC
- Psychiatry Physician
- Fairlawn, OH
National Provider Identifier
1346886751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Legal business name
- NORTHEAST PSYCHIATRY ASSOCIATES LLC
- Practice address
- 3610 W Market St Ste 103
Fairlawn, OH 44333-9301 - Phone
- (330) 576-3048
- Fax
- (234) 466-8025
- NPI assigned
- Nov 20, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Manzoor Elahi, MD
- Title
- Member
- Phone
- (330) 576-3048
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | Primary |
Addresses
Primary practice location
3610 W Market St Ste 103
Fairlawn, OH 44333-9301
Mailing address
3610 W Market St Ste 103
Fairlawn, OH 44333-9301
Phone (330) 576-3048
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0383096 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
3610 W Market St
Ste 103
Fairlawn, OH 44333
Phone (330) 576-3048
3610 W Market St
Ste 102
Fairlawn, OH 44333
Phone (330) 666-5004
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatry Physician
- Akron, OH
- NPI 1174621221
-
- Psychiatry Physician
- Akron, OH
- NPI 1083702237
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574208000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1709942400000",
"number": "1346886751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3610 W MARKET ST STE 103",
"city": "FAIRLAWN",
"state": "OH",
"postal_code": "443339301",
"telephone_number": "330-576-3048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3610 W MARKET ST STE 103",
"city": "FAIRLAWN",
"state": "OH",
"postal_code": "443339301",
"telephone_number": "330-576-3048",
"fax_number": "234-466-8025"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHEAST PSYCHIATRY ASSOCIATES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-11-20",
"last_updated": "2024-03-09",
"certification_date": "2024-03-09",
"status": "A",
"authorized_official_last_name": "ELAHI",
"authorized_official_first_name": "MANZOOR",
"authorized_official_title_or_position": "MEMBER",
"authorized_official_telephone_number": "330-576-3048",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0383096",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fairlawn, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.