Individual provider Active NPI

Alice G McIntyre, MD

  • Pediatrics Physician
  • Avon, OH
National Provider Identifier
1639257173
Registry record updated Sep 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35085884 Issued in OH
Practice address
36901 American Way
Suite C
Avon, OH 44011-4057
Phone
(440) 899-5550
Fax
(440) 899-5674
NPI assigned
Nov 1, 2006
Last updated
Sep 13, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35085884 OH Primary

Addresses

Primary practice location

36901 American Way
Suite C
Avon, OH 44011-4057

Mailing address

36901 American Way
Suite C
Avon, OH 44011-4057
Phone (440) 899-5550

Other identifiers 1

IdentifierTypeStateIssuer
2588703MedicaidOH

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
I20050809001011 OH Practitioner - Pediatric MedicinePractitioner - Internal Medicine 2163451287 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35085884OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
The Cleveland Clinic Foundation CurrentSince May 31, 2016 Accepting new patients
Lakewood Hospital Association Past Accepting new patients
Lakewood Hospital Association Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
The Cleveland Clinic Foundation Past Accepting new patients

Locations

36901 American Way
Ste C
Avon, OH 44011
Phone (440) 899-5550

18101 Lorain Ave
Cleveland, OH 44111
Phone (216) 476-7029

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

14601 Detroit Ave
Lakewood, OH 44107
Phone (216) 237-5500

Interoperability endpoints

  • Direct secure messaging: amcintyremd59303@direct.ccf.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189641600000",
    "number": "1639257173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36901 AMERICAN WAY",
            "address_2": "SUITE C",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440114057",
            "telephone_number": "440-899-5550",
            "fax_number": "440-899-5674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36901 AMERICAN WAY",
            "address_2": "SUITE C",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440114057",
            "telephone_number": "440-899-5550",
            "fax_number": "440-899-5674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "ALICE",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35085884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2588703",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, OH

Sources for this page

Verify at the official NPI Registry.