Ruben T Agra MD and Lolita R. Agra MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35034511 Issued in OH

Legal business name

RUBEN T AGRA MD AND LOLITA R. AGRA MD

Doing business as

Olympia Medical Clinic

Practice address

3361 E 55TH Street
Cleveland, OH 44127-1547

Phone

(216) 441-0660

Fax

(216) 441-7261

NPI assigned

Oct 20, 2006

Organization subpart

No

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

Authorized official

Name

Lolita R Agra, MD

Title

Medical Doctor

Phone

(216) 441-0660

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Olympia Medical Clinic Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samson Ballesteros, M.D.

  • Internal Medicine Physician
  • Parma, OH
  • NPI 1548350978
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443657600000",
    "number": "1467534198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 770502",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441070027",
            "telephone_number": "440-930-0609",
            "fax_number": "440-653-9889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3361 E 55TH STREET",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441271547",
            "telephone_number": "216-441-0660",
            "fax_number": "216-441-7261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUBEN T AGRA MD AND LOLITA R. AGRA MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2015-10-01",
        "status": "A",
        "authorized_official_last_name": "AGRA",
        "authorized_official_first_name": "LOLITA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "216-441-0660",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35034511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0719824",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Olympia Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chayatat Ruangkit, MD
• Ana Lucia Ruano Mendez, MD
• Tristan Ruark
• Amal Salim Rubai, MD
• Christa Rubbelke
• Alissa Rubin
• Batsheva Reich Rubin
• Benjamin Rubin, LISW
• Brian P Rubin, MD
• Kasia Rubin, MD.

• Family Medicine Physician in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.