Individual provider Active NPI

Maxime Freire, MD

  • Diagnostic Radiology Physician
  • Cleveland, OH
National Provider Identifier
1396918017
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
21427 Issued in MS
Practice address
9500 Euclid Ave # A21
Cleveland, OH 44195-4500
Phone
(800) 223-2273
NPI assigned
Apr 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 769-L MS
Diagnostic Radiology Physician 2085R0202X 57.011402 OH
Diagnostic Radiology Physician 2085R0202X 21427 MS Primary

Addresses

Primary practice location

9500 Euclid Ave # A21
Cleveland, OH 44195-4500

Mailing address

21125 Shelburne Rd
Shaker Heights, OH 44122-1946
Phone (216) 219-1080

Other identifiers 3

IdentifierTypeStateIssuer
P01189939OtherMSRAILROAD MEDICARE PTAN
158937MedicaidAL
06395191MedicaidMS

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
I20200619001689 OH Practitioner - Diagnostic Radiology 9234323916 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinic Medical Services CompanyGroup PAC ID 5698674653, 201 clinicians
Wooster Clinic LLCGroup PAC ID 6800708124, 290 clinicians
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

1000 E Washington St
Medina, OH 44256-2170
Phone (330) 721-5117

1740 Cleveland Rd
Wooster, OH 44691-2204
Phone (330) 287-4500

2420 Lake Ave
Ashtabula, OH 44004-4954
Phone (440) 997-2262

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

Hospital & facility affiliations

  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
  • Cleveland Clinic Avon Hospital Hospital, Avon, OH, CCN 360364
  • Fairview Hospital Hospital, Cleveland, OH, CCN 360077
  • Euclid Hospital Hospital, Euclid, OH, CCN 360082
  • Lutheran Hospital Hospital, Cleveland, OH, CCN 360087

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57.011402OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince May 13, 2020 Accepting new patients
Clinic Medical Services Company Diagnostic Radiology CurrentSince Jun 8, 2020 Accepting new patients
Clinic Medical Services Company LLC Diagnostic Radiology CurrentSince Jun 8, 2020 Accepting new patients
Wooster Clinic, LLC CurrentSince May 13, 2020 Accepting new patients
University Radiation Oncology Consultants, PLLC Past Accepting new patients

Locations

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

9500 Euclid Ave
#A21
Cleveland, OH 44195
Phone (216) 296-3737

6100 W Creek Rd
Ste 35
Independence, OH 44131
Phone (212) 986-1666

1740 Cleveland Rd
Wooster, OH 44691
Phone (330) 287-4500

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1207180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1396918017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21125 SHELBURNE RD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441221946",
            "telephone_number": "216-219-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE # A21",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441954500",
            "telephone_number": "800-223-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREIRE",
        "first_name": "MAXIME",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-03",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "769-L",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "57.011402",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "21427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P01189939",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158937",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06395191",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.