Larissa Elgudin, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

35080478E Issued in OH

Practice address

23425 Commerce Park Ste 104
Beachwood, OH 44122-5848

Phone

(216) 831-2900

Fax

(216) 831-4306

NPI assigned

Jun 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Psychiatry

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Debalzo, Elgudin. Levine, Risen LLCGroup PAC ID 3072880715, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lelgudin35953@ehrdirect.uhhospitals.org

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.

• Debalzo Elgudin Levine Risen LLC

  • Psychiatry Physician
  • Beachwood, OH
  • NPI 1396286191
  Medicare reassignment Care Compare group NPD Authorized official
• Coleman Professional Services, Inc.

  • Mental Health Counselor
  • Kent, OH
  • NPI 1982637633
  Medicare reassignment
• Chattree and Associates LTD

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Beachwood, OH
  • NPI 1962448654
  NPD (past)
• Portage Path Behavioral Health

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Akron, OH
  • NPI 1114492147
  NPD (past)
• Portage Path Community Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Akron, OH
  • NPI 1225087802
  NPD (past)
• State of Ohio Office of Budget and Management State Accounting

  • Nursing Facility/Intermediate Care Facility
  • Sandusky, OH
  • NPI 1790732576
  NPD (past)

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1629004387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23425 COMMERCE PARK",
            "address_2": "SUITE 104",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225844",
            "telephone_number": "216-831-2900",
            "fax_number": "216-831-4306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23425 COMMERCE PARK STE 104",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225848",
            "telephone_number": "216-831-2900",
            "fax_number": "216-831-4306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELGUDIN",
        "first_name": "LARISSA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35080478E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clara El Haddad
• El-Hallak Rheumatology and Specialty Infusion Services LLC
• Moussa El-Hallak, M.D.
• Jodi Eleff, DPM
• Elevate Foot & Ankle Inc
• Abd Elrahman Mohamed Elhassanin
• Sarah Elias
• Elite Dentistry Center LLC
• Elizabeth Harris PHD LLC
• Ellen F. Casper, PH.D. and Associates

• Psychiatry Physician in Beachwood, OH
• Providers in Beachwood, OH by specialty
• Psychiatry Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.