Organization Active NPI

North Shore Endoscopy Center

  • Gastroenterology Physician
  • Westlake, OH
National Provider Identifier
1467474585
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
NORTH SHORE ENDOSCOPY CENTER
Practice address
850 Columbia Rd Ste 200
Westlake, OH 44145-7215
Phone
(440) 808-1212
Fax
(440) 808-0321
NPI assigned
Jul 25, 2006
Last updated
Sep 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Authorized official

Name
Dr. Mousab I Tabbaa, MDNPI 1184642050
Title
President
Phone
(440) 808-1212

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NU Primary

Addresses

Primary practice location

850 Columbia Rd Ste 200
Westlake, OH 44145-7215

Mailing address

850 Columbia Rd Ste 200
Westlake, OH 44145-7215
Phone (440) 808-1212

Other practice location 1

7580 Northcliff Ave Ste 1000
Brooklyn, OH 44144-3271
Phone (440) 808-1212

Other identifiers 2

IdentifierTypeStateIssuer
490002928OtherOHRAILROAD MEDICARE
0226151MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040302000507 OH Part B Supplier - Ambulatory Surgical Center 7416844733 Practice locations: Brooklyn, OH; Westlake, OH

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
North Shore Endoscopy Center LTDCCN 36C0001063
Medicare certification status
ActiveFrom the Provider of Services file

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
North Shore Endoscopy Center LLCCCN 36C0001183
Medicare certification status
ActiveFrom the Provider of Services file

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
36D0903342North Shore Endoscopy Center850 Columbia Road Suite 200, Westlake, OH 44145Certificate of waiverAug 28, 2027
36D1017662North Shore Endoscopy Center7580 Northcliff Ave Suite 1000, Brooklyn, OH 44144Certificate of waiverSep 30, 2027

National Provider Directory

National Provider Directory

Locations

1 Infinity Corporate Centre Dr
#130E
Garfield Heights, OH 44125
Phone (216) 663-7064

1 Infinity Corporate Centre Dr
Ste 130
Garfield Hts, OH 44125
Phone (216) 663-7064

850 Columbia Rd
Ste 200
Westlake, OH 44145

Practitioners & affiliated clinicians

Practitioners 51

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 51

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758499200000",
    "number": "1467474585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 COLUMBIA RD STE 200",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441457215",
            "telephone_number": "440-808-1212",
            "fax_number": "440-808-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 COLUMBIA RD STE 200",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441457215",
            "telephone_number": "440-808-1212",
            "fax_number": "440-808-0321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7580 Northcliff Ave Ste 1000",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "OH",
            "postal_code": "441443271",
            "country_code": "US",
            "telephone_number": "440-808-1212",
            "fax_number": "440-808-0321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTH SHORE ENDOSCOPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A",
        "authorized_official_last_name": "TABBAA",
        "authorized_official_first_name": "MOUSAB",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-808-1212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "490002928",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0226151",
            "state": "OH"
        }
    ],
    "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 Sep 22, 2025; 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.