NPIMap

Organization Active NPI

Cleveland Vascular Surg Asoc

  • Specialist
  • Fairview Park, OH
National Provider Identifier
1467648014
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
35040353 Issued in OH
Legal business name
CLEVELAND VASCULAR SURG ASOC
Practice address
20997 Lorain Rd
Fairview Park, OH 44126-2030
Phone
(440) 356-1009
NPI assigned
Sep 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Authorized official

Name
Dr. Basem Droubi, M.D.
Title
Owner
Phone
(440) 356-1009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 35040353 OH Primary

Addresses

Primary practice location

20997 Lorain Rd
Fairview Park, OH 44126-2030

Mailing address

20997 Lorain Rd
Fairview Park, OH 44126-2030
Phone (440) 356-1009

Other identifiers 1

IdentifierTypeStateIssuer
0963533MedicaidOH

Other names 1

  • none Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190678400000",
    "number": "1467648014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20997 LORAIN RD",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441262030",
            "telephone_number": "440-356-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20997 LORAIN RD",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441262030",
            "telephone_number": "440-356-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND VASCULAR SURG ASOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-18",
        "last_updated": "2007-09-25",
        "status": "A",
        "authorized_official_last_name": "DROUBI",
        "authorized_official_first_name": "BASEM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-356-1009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OH",
            "license": "35040353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0963533",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "none",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairview Park, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; 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.