NPIMap

Organization Active NPI

Premier Physicians Centers, Inc

  • Clinical Medical Laboratory
  • Westlake, OH
National Provider Identifier
1396928883
Registry record updated Nov 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
PREMIER PHYSICIANS CENTERS, INC
Practice address
25200 Center Ridge Rd
Westlake, OH 44145-4141
Phone
(440) 895-5057
Fax
(440) 895-5050
NPI assigned
Dec 7, 2007
Last updated
Nov 20, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
PREMIER PHYSICIANS CENTERS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 20, 2020

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

Authorized official

Name
Mr. Dick Fintz
Title
Cfo
Phone
(440) 895-5056

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

25200 Center Ridge Rd
Westlake, OH 44145-4141

Mailing address

24500 Center Ridge Rd Ste 375
Westlake, OH 44145-5631
Phone (440) 895-5057

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080116000516 OH Part B Supplier - Independent Clinical Laboratory 0345153326 Practice locations: Westlake, OH

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0334618Premier Physicians Centers25200 Center Ridge Road, Westlake, OH 44145Certificate of waiverDec 22, 2027
36D0336123Premier Physicians Centers, Inc Lab25200 Center Ridge Road, Ste 1500a, Westlake, OH 44145AccreditationDec 22, 2027
36D0890613Premier Physicians Centers Inc25200 Center Ridge Road, Westlake, OH 44145Certificate of waiverDec 31, 2026
36D0935826Premier Physicians Centers in25200 Center Ridge Road, Westlake, OH 44145Certificate of waiverNov 6, 2027
36D0971947Premier Physicians Centers25200 Center Ridge Road, Westlake, OH 44145Certificate of waiverMar 26, 2028
36D0986194Premier Physicians Centers Inc25200 Center Ridge Rd, Westlake, OH 44145Certificate of waiverMay 9, 2027
36D2026418Premier Physicians Centers Inc25200 Center Ridge Road, Westlake, OH 44145Certificate of waiverJun 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
Premier Physicians Centers Inc14 organizations share this tax ID, including this one
Part of
Premier Physicians Centers Inc

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

15644 Madison Ave
Ste 218
Lakewood, OH 44107
Phone (216) 226-5778

Practitioners & affiliated clinicians

Practitioners 30

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.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605830400000",
    "number": "1396928883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24500 CENTER RIDGE RD STE 375",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455631",
            "telephone_number": "440-895-5057",
            "fax_number": "440-895-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25200 CENTER RIDGE RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441454141",
            "telephone_number": "440-895-5057",
            "fax_number": "440-895-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PHYSICIANS CENTERS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIER PHYSICIANS CENTERS, INC.",
        "enumeration_date": "2007-12-07",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A",
        "authorized_official_last_name": "FINTZ",
        "authorized_official_first_name": "DICK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "440-895-5056",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 20, 2020; 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.