Organization Active NPI

Northeast Ohio Medical Group

  • Internal Medicine Physician
  • Cleveland, OH
National Provider Identifier
1659445773
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NORTHEAST OHIO MEDICAL GROUP
Practice address
13944 Euclid Ave
Suite 103
Cleveland, OH 44112-3832
Phone
(216) 761-9617
NPI assigned
Nov 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Charles Abunyewa, MDNPI 1942238605
Title
Partner
Phone
(216) 761-9617

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

13944 Euclid Ave
Suite 103
Cleveland, OH 44112-3832

Mailing address

13944 Euclid Ave
Suite 103
Cleveland, OH 44112-3832
Phone (216) 761-9617

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidOH

National Provider Directory

National Provider Directory

Locations

13944 Euclid Ave
Ste 103
Cleveland, OH 44112
Phone (216) 761-9617

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659445773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13944 EUCLID AVE",
            "address_2": "SUITE 103",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441123832",
            "telephone_number": "216-761-9617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13944 EUCLID AVE",
            "address_2": "SUITE 103",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441123832",
            "telephone_number": "216-761-9617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST OHIO MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ABUNYEWA",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "216-761-9617",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.