Peter Bambakidis, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

35058627B Issued in OH

Practice address

25200 Center Ridge Rd
Ste 2100
Westlake, OH 44145

Phone

(440) 331-4053

Fax

(440) 331-4073

NPI assigned

Feb 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 14

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

Specialty

Neurology

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fairview Hospital Hospital, Cleveland, OH, CCN 360077
• Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
• Cleveland Clinic Avon Hospital Hospital, Avon, OH, CCN 360364
• Medina Hospital Hospital, Medina, OH, CCN 360091
• Lutheran Hospital Hospital, Cleveland, OH, CCN 360087

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pbambakidis92990@direct.ccf.org

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.

• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Medicare reassignment Care Compare group NPD
• Euclid Hospital Cleveland Clinic Health System

  dba cleveland clinic foundation

  • General Acute Care Hospital
  • Euclid, OH
  • NPI 1457403016
  NPD
• Premier Physicians Centers Inc

  • Durable Medical Equipment & Medical Supplies
  • Westlake, OH
  • NPI 1679201479
  NPD (past)
• Premier Physicians Centers, Inc

  • Clinical Medical Laboratory
  • Westlake, OH
  • NPI 1396928883
  NPD (past)

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

• Cleveland Clinic Avon Hospital

  • General Acute Care Hospital
  • Avon, OH
  • NPI 1346607017
  Care Compare affiliation
• Fairview Hospital

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1215989611
  Care Compare affiliation
• Lutheran Hospital

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1194763045
  Care Compare affiliation
• Medina Hospital

  • General Acute Care Hospital
  • Medina, OH
  • NPI 1083696710
  Care Compare affiliation
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Care Compare affiliation

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211846400000",
    "number": "1598731275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20525 CENTER RIDGE RD",
            "address_2": "STE 220",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "44116",
            "telephone_number": "440-895-5056",
            "fax_number": "440-333-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25200 CENTER RIDGE RD",
            "address_2": "STE 2100",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "44145",
            "telephone_number": "440-331-4053",
            "fax_number": "440-331-4073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAMBAKIDIS",
        "first_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2008-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OH",
            "license": "35058627B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000246863",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP RR MEDICARE",
            "identifier": "CA4511",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4117752",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID",
            "identifier": "0119204",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "9273172",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "102920",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10788157",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUMMACARE APEX",
            "identifier": "F58622",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1780634279",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "341783789093",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP ASC MEDICARE",
            "identifier": "3610861",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0501061",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0749284",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP IND DIAGNOSTICS MED",
            "identifier": "D3683041",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in Westlake, OH
• Providers in Westlake, OH by specialty
• Neurology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.