The Metrohealth System
Organization Active NPI Federally Qualified Health Center (FQHC) · Cleveland, OH
NPI 1346919362 · NPPES record last updated May 9, 2024
Key facts
- NPI
- 1346919362
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- THE METROHEALTH SYSTEM
- Practice address
- 6835 Broadway Ave
Cleveland, OH 44105-1313 - Phone
- (216) 957-1850
- Fax
- (216) 957-1695
- NPI assigned
- Sep 13, 2021
- Organization subpart
- Yes
- Parent organization (as reported)
- THE METROHEALTH SYSTEM
Authorized official
- Name
- Derrick Hollings
- Title
- Evp/Cfo
- Phone
- (216) 778-7800
Owners & managing parties with NPI records 23
Owned or controlled facilities with NPI records 6
Other NPIs with the same Medicare PAC ID 23
Corporate family (same tax ID) 37
Facilities with the same owner 6
Practitioners 1,150
-
Ala' A.H. Abdel Jalil, M.D.
-
Laura Abounader, APRN-CNP
-
Stephani F Ackerman-Werner, AU.D, CCC-A
-
Danielle Adkins, CNP
-
Andrea Adoni, CNP
-
Margaret Owusu Afari, PA-C
-
Subhan Ahmad, M.D.
-
Shamima Y Ahmed, MD
-
Payal Ahuja, M.D.
-
Syed Mahfuzul Alam, M.D., PH.D.
-
Michael Allen, LPCC
-
Soufian Almahameed, M.D.
-
Jonathan Alan Alter, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Federally qualified health center certification: CCN 721941
- Legal name
- THE METROHEALTH SYSTEM
- Doing business as
- BROADWAY DENTAL CLINIC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jan 19, 2022
- Last certification
- Jan 19, 2022
- Ownership / control type
- For profit – corporation
- Organization structure
- Other · Non-profit
- Enrollment address
- 6835 Broadway Ave
Cleveland, OH 44105-1313
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Ezelle Harry Walker |
Corporate Director |
Jul 1, 2021 | |
| Geoff Himes |
Corporate Officer |
Jul 1, 2021 | |
| W-2 Managing Employee |
Jul 1, 2021 | ||
| Daniel Lewis |
Corporate Officer |
Jul 1, 2021 | |
| Corporate Director |
Jul 1, 2021 | ||
| Brenda Roth-Metzger |
Corporate Director |
Jul 1, 2021 | |
| Joseph Varga |
W-2 Managing Employee |
Jul 1, 2021 | |
| Debra Abercrumbie |
Corporate Director |
Jul 1, 2021 | |
| Hazel Owens |
Corporate Director |
Jul 1, 2021 | |
| Linda Ryan-Allen |
Corporate Director |
Jul 1, 2021 | |
| Ron Fountain |
Corporate Officer |
Jul 1, 2021 | |
| Corporate Director |
Jul 1, 2021 | ||
| Shirley Jordan Seay |
Corporate Officer |
Jul 1, 2021 | |
| Corporate Director |
Jul 1, 2021 | ||
| The Metrohealth System |
5% Or Greater Direct Ownership Interest | Jul 1, 2021 | 100% |
All facility ownership & control disclosures 6
| Facility | Type | Role | Since |
|---|---|---|---|
| Brooklyn Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Feb 5, 2024 |
| Gordon Square Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Feb 2, 2024 |
| Heights Wellnes Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest | Feb 7, 2024 |
| Collinwood Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Feb 7, 2024 |
| Buckeye Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Feb 7, 2024 |
| Bedford Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest | Feb 7, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220208001185 | OH | Part a Provider - Federally Qualified Health Center (FQHC) | 8628982949 | Practice locations: Cleveland, OH |
National Provider Directory
- Tax ID family
- Metrohealth West Park
- Part of
- Metrohealth West Park
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
6835 Broadway Ave
Cleveland, OH 44105-1313
Mailing address
2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone (216) 778-7800
Other names
- MetroHealth Broadway Health Center
Other providers in Cleveland, OH
- The Metrohealth System
- The Metrohealth System
- The Metrohealth System
- The Metrohealth System
- The Metrohealth System
- The Metrohealth System
- The Metrohealth System
- The Metrohealth System
- The Metrohealth System
- The Metrohealth System
All providers in Cleveland, OH · Federally Qualified Health Center (FQHC) in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.