Individual provider Active NPI

Mariam Ahmad Diab, M.D

  • Emergency Medicine Physician
  • Cleveland, OH
National Provider Identifier
1548536691
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35.127078 Issued in OH
Practice address
2351 East 22ND Street
St Vincent Charity Medical Centre
Cleveland, OH 44115
Phone
(216) 482-1087
NPI assigned
Mar 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35.127078 OH Primary

Addresses

Primary practice location

2351 East 22ND Street
St Vincent Charity Medical Centre
Cleveland, OH 44115

Mailing address

3420 Wooster Rd
515
Rocky River, OH 44116-4174
Phone (216) 482-1087

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160627001234 OH Practitioner - Emergency Medicine 6406147214 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Professional Services, Inc.Group PAC ID 7214832435, 121 clinicians

Practice addresses (Care Compare)

2351 E 22ND St
St Vincent Hospital
Cleveland, OH 44115-3111
Phone (216) 363-2536

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professional Services, Inc. Emergency Medicine CurrentSince Jun 1, 2016 Accepting new patients
Mercy Emergency Care Services, Inc. Emergency Medicine CurrentSince Jun 15, 2016 Accepting new patients

Locations

2351 E 22nd St
Cleveland, OH 44115
Phone (216) 363-2536

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

2600 Navarre Ave
Oregon, OH 43616
Phone (419) 696-7200

1100 Neal Zick Rd
Willard, OH 44890
Phone (419) 964-5000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1548536691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 WOOSTER RD",
            "address_2": "515",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441164174",
            "telephone_number": "216-482-1087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 EAST 22ND STREET",
            "address_2": "ST VINCENT CHARITY MEDICAL CENTRE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44115",
            "telephone_number": "216-482-1087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAB",
        "first_name": "MARIAM",
        "middle_name": "AHMAD",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-22",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.127078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.