NPIMap

Individual provider Active NPI

Stephen Archacki, MD

  • Internal Medicine Physician
  • Euclid, OH
National Provider Identifier
1376526053
Registry record updated Mar 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35-069237 Issued in OH
Practice address
34500 Chardon Road
Suite 6
Euclid, OH 44094-3305
Phone
(440) 386-4200
Fax
(440) 943-4184
NPI assigned
Nov 28, 2005
Last updated
Mar 30, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35-069237 OH Primary

Addresses

Primary practice location

34500 Chardon Road
Suite 6
Euclid, OH 44094-3305

Mailing address

34500 Chardon Road
Suite 6
Euclid, OH 44094-3305
Phone (440) 386-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060331000590 OH Practitioner - Internal Medicine 1759399785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-2200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-069237OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Dec 11, 2019 Accepting new patients
Cleveland Clinic Health System - East Region Past Accepting new patients
The Cleveland Clinic Foundation Past 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

99 Northline Cir
Ste 102
Euclid, OH 44119
Phone (216) 312-4295

5187 Mayfield Rd
Ste 20
Lyndhurst, OH 44124

34500 Chardon Rd
Willoughby Hills, OH 44094
Phone (440) 386-4200

34500 Chardon Rd
Ste 6
Willoughby Hills, OH 44094
Phone (440) 386-2009

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 10

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": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459296000000",
    "number": "1376526053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34500 CHARDON ROAD",
            "address_2": "SUITE 6",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "440943305",
            "telephone_number": "440-386-4200",
            "fax_number": "440-943-4184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34500 CHARDON ROAD",
            "address_2": "SUITE 6",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "440943305",
            "telephone_number": "440-386-4200",
            "fax_number": "440-943-4184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHACKI",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2016-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-069237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Euclid, OH

Sources for this page

Verify at the official NPI Registry.