Organization Active NPI

University Primary Care Practices Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Westlake, OH
National Provider Identifier
1376754887
Registry record updated Apr 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
UNIVERSITY PRIMARY CARE PRACTICES INC
Practice address
29101 Health Campus Dr BLDG 2 # 295
Westlake, OH 44145-5270
Phone
(440) 808-5950
Fax
(440) 250-0363
NPI assigned
May 25, 2007
Last updated
Apr 14, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2010

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

Authorized official

Name
Mr. Steve Riddle
Title
Director of Billing Services
Phone
(216) 383-6480

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X OH Primary

Addresses

Primary practice location

29101 Health Campus Dr BLDG 2 # 295
Westlake, OH 44145-5270

Mailing address

PO Box 8792
Belfast, ME 04915-8792
Phone (440) 808-5950

Other names 1

  • ROGER PECKHAM MD Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031125000767 OH Part B Supplier - Clinic/Group Practice 3072417534 Receives reassigned benefits from 1,508 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271203200000",
    "number": "1376754887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8792",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049158792",
            "telephone_number": "440-808-5950",
            "fax_number": "440-250-0363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29101 HEALTH CAMPUS DR BLDG 2 # 295",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455270",
            "telephone_number": "440-808-5950",
            "fax_number": "440-250-0363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PRIMARY CARE PRACTICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2010-04-14",
        "status": "A",
        "authorized_official_last_name": "RIDDLE",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING SERVICES",
        "authorized_official_telephone_number": "216-383-6480",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROGER PECKHAM MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Westlake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2010; 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.

Verify at the official NPI Registry.