Individual provider Active NPI

Robert J. Haller, M.D.

  • Diagnostic Radiology Physician
  • Cleveland, OH
National Provider Identifier
1639113293
Registry record updated Jun 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
059535 Issued in OH
Practice address
4853 Galaxy Pkwy
Suite I
Cleveland, OH 44128-5973
Phone
(216) 831-9786
Fax
(216) 831-2425
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 059535 OH Primary

Addresses

Primary practice location

4853 Galaxy Pkwy
Suite I
Cleveland, OH 44128-5973

Mailing address

4853 Galaxy Pkwy
Suite I
Cleveland, OH 44128-5973
Phone (216) 831-9786

Other identifiers 2

IdentifierTypeStateIssuer
2143120MedicaidOH
0220291MedicaidOH

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051024000157 OH Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 6901822402 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbus Radiology CorpGroup PAC ID 6507754983, 290 clinicians

Practice addresses (Care Compare)

18697 Bagley Rd
Middlebrg HTS, OH 44130-3417
Phone (440) 816-8716

Hospital & facility affiliations

  • Southwest General Health Center Hospital, Middleburg Heights, OH, CCN 360155
  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
  • Parma Community General Hospital Hospital, Parma, OH, CCN 360041

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
059535OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Radiology Corp Diagnostic Radiology CurrentSince Aug 27, 2019 Accepting new patients
Radiology Associates of Canton, Inc Diagnostic Radiology CurrentSince Oct 1, 2020 Accepting new patients
University Hospitals Medical Group Inc Diagnostic Radiology CurrentSince Jan 1, 2016 Accepting new patients
Radiology Associates of Canton, Inc. Diagnostic Radiology CurrentSince Oct 1, 2020 Accepting new patients
Multicare Health System Past Accepting new patients
DRS. Hill & Thomas Co. Past Accepting new patients

Locations

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

2131 Lake Ave
Ashtabula, OH 44004
Phone (440) 998-2222

2600 6th St SW
Canton, OH 44710
Phone (330) 363-2180

7066 Fulton Dr NW
Canton, OH 44718
Phone (330) 363-8567

1020 Trump Rd NW
Carrollton, OH 44615
Phone (330) 627-0091

13207 Ravenna Rd
Chardon, OH 44024
Phone (440) 285-5004

3999 Richmond Rd
Cleveland, OH 44122
Phone (216) 293-8226

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

11100 Euclid Ave
Cleveland Heights, OH 44106

111 S Grant Ave
Columbus, OH 43215
Phone (614) 461-3232

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

20800 Harvard Rd
Fl 2
Highland Hills, OH 44122
Phone (216) 358-2156

875 8th St NE
Massillon, OH 44646
Phone (216) 832-8761

6780 Mayfield Rd
Mayfield Hts, OH 44124
Phone (440) 331-9520

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

6100 Whipple Ave NW
North Canton, OH 44720
Phone (330) 244-8778

832 S Main St
Orrville, OH 44667
Phone (330) 456-2695

18181 Pearl Rd
Strongsville, OH 44136
Phone (440) 816-4976

Organizations & group practices 6

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 3

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403654400000",
    "number": "1639113293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4853 GALAXY PKWY",
            "address_2": "SUITE I",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441285973",
            "telephone_number": "216-831-9786",
            "fax_number": "216-831-2425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4853 GALAXY PKWY",
            "address_2": "SUITE I",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441285973",
            "telephone_number": "216-831-9786",
            "fax_number": "216-831-2425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLER",
        "first_name": "ROBERT",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2014-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "059535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2143120",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0220291",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.