Organization Active NPI

Brown Medical Center, Inc.

  • Endocrinology, Diabetes & Metabolism Physician
  • Cleveland, OH
National Provider Identifier
1619095049
Registry record updated Nov 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
BROWN MEDICAL CENTER, INC.
Practice address
1831 Forest Hills Blvd
Suite 105
Cleveland, OH 44112-4348
Phone
(216) 451-2030
Fax
(216) 451-2027
NPI assigned
Mar 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2014

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

Authorized official

Name
Dr. Delorise Brown, M.D.NPI 1023129079
Title
President
Phone
(216) 451-2030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Adolescent Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0000X
Adult Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0505X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Legal Medicine (M.D./D.O.) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 209800000X

Addresses

Primary practice location

1831 Forest Hills Blvd
Suite 105
Cleveland, OH 44112-4348

Mailing address

1831 Forest Hills Blvd
Suite 105
Cleveland, OH 44112-4348
Phone (216) 451-2030

Other identifiers 10

IdentifierTypeStateIssuer
000000168701OtherOHANTHEM GROUP PROVIDER ID
50821OtherOHQUALCHOICE PROVIDER ID
587127472010OtherOHMEDICAL MUTUAL OF OHIO ID
716326MedicaidOH
R39059OtherOHSUMMACARE PROVIDER ID
366373800OtherOHUS DEPARTMENT OF LABOR ID
350477OtherOHWELLCARE HEALTH PLANS ID
350477MedicaidOH
0420315MedicaidOH
366373800OtherOHFEDERAL WORKERS COMP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080409000781 OH Part B Supplier - Clinic/Group Practice 3072690486 Receives reassigned benefits from 1 practitioner
Practice locations: East Cleveland, OH

National Provider Directory

National Provider Directory

Locations

1831 Forest Hills Blvd
Ste 105
East Cleveland, OH 44112
Phone (216) 359-2556

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414972800000",
    "number": "1619095049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1831 FOREST HILLS BLVD",
            "address_2": "SUITE 105",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441124348",
            "telephone_number": "216-451-2030",
            "fax_number": "216-451-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1831 FOREST HILLS BLVD",
            "address_2": "SUITE 105",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441124348",
            "telephone_number": "216-451-2030",
            "fax_number": "216-451-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWN MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2014-11-03",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "DELORISE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-451-2030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "209800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Legal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM GROUP PROVIDER ID",
            "identifier": "000000168701",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE PROVIDER ID",
            "identifier": "50821",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL OF OHIO ID",
            "identifier": "587127472010",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "716326",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUMMACARE PROVIDER ID",
            "identifier": "R39059",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPARTMENT OF LABOR ID",
            "identifier": "366373800",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE HEALTH PLANS ID",
            "identifier": "350477",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "350477",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0420315",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL WORKERS COMP",
            "identifier": "366373800",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.