Individual provider Active NPI

Brandon Edward Mooney, MT, PA-C

  • Medical Physician Assistant
  • Cleveland, OH
National Provider Identifier
1609102276
Registry record updated Nov 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
50.001593 Issued in OH
Practice address
9500 Euclid Ave
Desk Q10-1
Cleveland, OH 44195-0001
Phone
(216) 444-3958
Fax
(216) 444-7031
NPI assigned
Nov 2, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 50.001593 OH Primary

Addresses

Primary practice location

9500 Euclid Ave
Desk Q10-1
Cleveland, OH 44195-0001

Mailing address

9500 Euclid Ave
Desk Q10-1
Cleveland, OH 44195-0001
Phone (216) 444-3958

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100415000356 OH Practitioner - Physician Assistant 1951438423 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians
Wooster Clinic LLCGroup PAC ID 6800708124, 290 clinicians

Practice addresses (Care Compare)

16761 Southpark Ctr
Strongsville, OH 44136-9302
Phone (440) 878-2500

1740 Cleveland Rd
Wooster, OH 44691-2204
Phone (330) 287-4500

5001 Rockside Rd
Independence, OH 44131-2172
Phone (216) 986-4000

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Medical Technician, Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.001593OHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wooster Clinic, LLC CurrentSince May 1, 2013 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Feb 16, 2010 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Feb 16, 2010 Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

9500 Euclid Ave
#Q101
Cleveland, OH 44195
Phone (216) 636-9483

1761 Beall Ave
Wooster, OH 44691
Phone (330) 263-8100

1740 Cleveland Rd
Wooster, OH 44691
Phone (330) 287-4500

Organizations & group practices 3

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

Hospital & facility affiliations 5

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": "1257120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257120000000",
    "number": "1609102276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "address_2": "DESK Q10-1",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-444-3958",
            "fax_number": "216-444-7031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "address_2": "DESK Q10-1",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-444-3958",
            "fax_number": "216-444-7031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONEY",
        "first_name": "BRANDON",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "MT, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-02",
        "last_updated": "2009-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.001593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.