Individual provider Active NPI

David Gutman, M.D.

  • Internal Medicine Physician
  • Beachwood, OH
National Provider Identifier
1396713749
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35-08-3362-G Issued in OH
Practice address
25200 Chagrin Blvd Ste 109
Beachwood, OH 44122-5681
Phone
(216) 772-4653
NPI assigned
Mar 10, 2006
Last updated
Apr 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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 35-08-3362-G OH Primary

Addresses

Primary practice location

25200 Chagrin Blvd Ste 109
Beachwood, OH 44122-5681

Mailing address

2361 Beachwood Blvd
Beachwood, OH 44122-1474
Phone (216) 291-2760

Other practice location 1

2660 W Market St Ste 250
Fairlawn, OH 44333-4210
Phone (216) 772-4653

Other identifiers 1

IdentifierTypeStateIssuer
2497132MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040716001184 OH Practitioner - Internal Medicine 9335128867 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, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

25200 Chagrin Blvd
Suite 109
Beachwood, OH 44122-5681
Phone (216) 772-4653

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Hemorrhoid Specialists, Inc. Internal Medicine CurrentSince Jan 1, 2007 Accepting new patients
Lake Erie Medical Group, Inc. Past Accepting new patients
Lake Erie Seniors, Inc. Past Accepting new patients
Uhhs Bedford Internal Medicine Past Accepting new patients

Locations

25200 Chagrin Blvd
Ste 109
Beachwood, OH 44122
Phone (216) 772-4653

2660 W Market St
Ste 250
Fairlawn, OH 44333
Phone (216) 772-4653

8224 Mentor Ave
Ste 132
Mentor, OH 44060
Phone (440) 290-8956

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1396713749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2361 BEACHWOOD BLVD",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441221474",
            "telephone_number": "216-291-2760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25200 CHAGRIN BLVD STE 109",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225681",
            "telephone_number": "216-772-4653"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2660 W Market St Ste 250",
            "address_purpose": "LOCATION",
            "city": "Fairlawn",
            "state": "OH",
            "postal_code": "443334210",
            "country_code": "US",
            "telephone_number": "216-772-4653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTMAN",
        "first_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-08-3362-G",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2497132",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.