Individual provider Active NPI

Rinku X Mukherjee

  • Geriatric Medicine (Internal Medicine) Physician
  • Cleveland, OH
National Provider Identifier
1649386350
Registry record updated Aug 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
35-095666 Issued in OH
Practice address
11100 Euclid Ave
Hanna House
Cleveland, OH 44106-1716
Phone
(216) 844-1262
NPI assigned
Aug 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0061343 MD
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 35-095666 OH Primary

Addresses

Primary practice location

11100 Euclid Ave
Hanna House
Cleveland, OH 44106-1716

Mailing address

24701 Euclid Ave
Euclid, OH 44117-1714
Phone (216) 844-1262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070219000204 MD Practitioner - Internal Medicine 0244332435 Reassigns benefits to 2 organizations
I20190724000171 DC Practitioner - Internal Medicine 0244332435 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0061343MDMDInternal Medicine Physician
35-095666OHMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Hospital Center, Inc Internal Medicine CurrentSince Jul 1, 2014 Accepting new patients
Praveen Bolarum, MD LLC CurrentSince Mar 12, 2019 Accepting new patients
Northwest Hospital Center, Inc. CurrentSince Jul 1, 2014 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

196 Thomas Johnson Dr
Ste 135
Frederick, MD 21702
Phone (301) 200-5639

10714 Potomac Tennis Ln
Potomac, MD 20854
Phone (301) 299-2273

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

Organizations & group practices 4

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314662400000",
    "number": "1649386350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24701 EUCLID AVE",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441171714",
            "telephone_number": "216-844-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE",
            "address_2": "HANNA HOUSE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061716",
            "telephone_number": "216-844-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKHERJEE",
        "first_name": "RINKU",
        "middle_name": "X",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2011-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0061343",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "OH",
            "license": "35-095666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.