Active NPI
Constantinos P Anastassiades, MD
- Gastroenterology Physician
- Cleveland, OH
National Provider Identifier
1437290053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 35-096540
- Practice address
- 11100 Euclid Ave
Wearn 247
Cleveland, OH 44106-1716 - Phone
- (216) 844-5386
- Fax
- (216) 983-0347
- NPI assigned
- Feb 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 35.096540 | OH | |
| Gastroenterology Physician | 207RG0100X | 35-096540 | OH | Primary |
Addresses
Primary practice location
11100 Euclid Ave
Wearn 247
Cleveland, OH 44106-1716
Mailing address
24701 Euclid Ave
3Rd Floor
Euclid, OH 44117-1714
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 866485000 | Medicaid | MN | |
| 0068576 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35-096540 | OH | MD | Gastroenterology Physician |
| 35.096540 | OH | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354665600000",
"number": "1437290053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24701 EUCLID AVE",
"address_2": "3RD FLOOR",
"city": "EUCLID",
"state": "OH",
"postal_code": "441171714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11100 EUCLID AVE",
"address_2": "WEARN 247",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441061716",
"telephone_number": "216-844-5386",
"fax_number": "216-983-0347"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANASTASSIADES",
"first_name": "CONSTANTINOS",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-08",
"last_updated": "2012-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "OH",
"license": "35.096540",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "OH",
"license": "35-096540",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "866485000",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0068576",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.