Embassy Euclid, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

EMBASSY EUCLID, LLC

Practice address

3 Gateway Drive
Euclid, OH 44119-2447

Phone

(216) 486-4949

NPI assigned

Aug 27, 2021

Organization subpart

No

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

Authorized official

Name

Nicholas Ciccone

Title

Chief Compliance Officer

Phone

(216) 378-2050

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrew Kwabena Brobbey, MD

  • Internal Medicine Physician
  • Euclid, OH
  • NPI 1679554877
  NPD (past)
• Jason Adam Gregorin, D.O.

  • Internal Medicine Physician
  • Cleveland, OH
  • NPI 1972982726
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630022400000",
    "number": "1366119265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25201 CHAGRIN BLVD STE 190",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225633",
            "telephone_number": "216-378-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 GATEWAY DRIVE",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441192447",
            "telephone_number": "216-486-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBASSY EUCLID, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-27",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A",
        "authorized_official_last_name": "CICCONE",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "216-378-2050"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "1890N",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shenya L Ellis
• India Patrice Ellison
• Angel Elston
• Brittany Elston
• Emanuel Health Center LLC
• Embassy Euclid, LLC
• Embracing Touch Nursing Services LLC
• Jill Tara Enders
• Enduring the Course Inc
• Epic Care Facilities LLC

• Skilled Nursing Facility in Euclid, OH
• Providers in Euclid, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.