Individual provider Active NPI

Mohammad Iravani, PA-C

  • Physician Assistant
  • Cleveland, OH
National Provider Identifier
1669429981
Registry record updated Jun 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50001923 Issued in OH
Practice address
1730 W 25TH St
Cleveland, OH 44113-3108
Phone
(216) 696-4300
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50001923 OH Primary

Addresses

Primary practice location

1730 W 25TH St
Cleveland, OH 44113-3108

Mailing address

3843 Savoy Dr
3
Fairview Park, OH 44126-1719
Phone (440) 506-3058

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040915000300 OH Practitioner - Physician Assistant 3577530989 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50001923OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Incare Health Solutions, LLC Physician Assistant CurrentSince Feb 13, 2018 Accepting new patients
The Metrohealth System CurrentSince Jan 1, 2021 Accepting new patients
The Metrohealth System Current Accepting new patients
Emergency Services of Central Ohio LLC Past Accepting new patients
Geriatric Physician Assistants LLC Physician Assistant Past Accepting new patients
Emergency Professionals of Ohio, Inc. Physician Assistant Past Accepting new patients

Locations

9200 Treeworth Blvd
Brecksville, OH 44141
Phone (216) 957-9000

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

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

10 Severance Cir
Cleveland Heights, OH 44118
Phone (216) 297-2600

7450 State Route 161 E
Plain City, OH 43064
Phone (614) 504-5002

25200 Center Ridge Rd
Ste 2300
Westlake, OH 44145
Phone (440) 331-5053

Interoperability endpoints

  • Direct secure messaging: miravani202835@direct.metrohealth.org
  • Direct secure messaging: miravani39753@ehrdirect.uhhospitals.org

Organizations & group practices 10

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": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243987200000",
    "number": "1669429981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3843 SAVOY DR",
            "address_2": "3",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441261719",
            "telephone_number": "440-506-3058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 W 25TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441133108",
            "telephone_number": "216-696-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRAVANI",
        "first_name": "MOHAMMAD",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2009-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50001923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.