Individual provider Active NPI

Solomon G Zaraa, D.O.

  • Child & Adolescent Psychiatry Physician
  • Cleveland, OH
National Provider Identifier
1619170990
Registry record updated Jul 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
34.009505 Issued in OH
Practice address
10524 Euclid Ave
Cleveland, OH 44106-2205
Phone
(216) 844-3881
Fax
(216) 844-5883
NPI assigned
Jun 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 34.009505 OH Primary

Addresses

Primary practice location

10524 Euclid Ave
Cleveland, OH 44106-2205

Mailing address

24701 Euclid Ave
3Rd Floor
Euclid, OH 44117-1714

Other identifiers 1

IdentifierTypeStateIssuer
3142138MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20191028002315 IL Practitioner - Psychiatry 3173715000 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.009505OHMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rosecrance Inc CurrentSince Oct 15, 2019 Accepting new patients
Rosecrance Inc Current Accepting new patients
Rosecrance Inc CurrentSince Oct 15, 2019 Accepting new patients
Portage Path Community Mental Health Center Past Accepting new patients
Portage Path Behavioral Health Past Accepting new patients

Locations

801 N Walnut St
Champaign, IL 61820
Phone (217) 356-1558

2302 Moreland Blvd
Champaign, IL 61822
Phone (217) 355-1697

422 Tracy Ct
Crystal Lake, IL 60014
Phone (815) 363-6132

20635 Abbey Woods Ct N
Ste 310
Frankfort, IL 60423
Phone (888) 928-0144

505 S Schuyler Ave
Ste 105
Kankakee, IL 60901
Phone (815) 720-4975

47 6th Ave
Ste L
La Grange, IL 60525
Phone (708) 469-7912

2704 N Main St
Rockford, IL 61103
Phone (815) 720-5012

605 Mulberry St
Rockford, IL 61103
Phone (815) 720-4960

1601 University Dr
Rockford, IL 61107
Phone (815) 387-2500

3815 Harrison Ave
Rockford, IL 61108
Phone (805) 391-1000

1021 N Mulford Rd
Rockford, IL 61107
Phone (815) 387-5600

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310428800000",
    "number": "1619170990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24701 EUCLID AVE",
            "address_2": "3RD FLOOR",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441171714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10524 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441062205",
            "telephone_number": "216-844-3881",
            "fax_number": "216-844-5883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZARAA",
        "first_name": "SOLOMON",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2011-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OH",
            "license": "34.009505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3142138",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.