Individual provider Active NPI

Maura A Gavin, PA-C

  • Physician Assistant
  • Beachwood, OH
National Provider Identifier
1669530663
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50-001272 Issued in OH
Practice address
4110 Warrensville Center Rd
Beachwood, OH 44122-7024
Phone
(216) 491-6000
NPI assigned
Dec 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 50-001272 OH Primary

Addresses

Primary practice location

4110 Warrensville Center Rd
Beachwood, OH 44122-7024

Mailing address

PO Box 74647
Cleveland, OH 44194-0730
Phone (440) 879-0081

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
I20061214000260 OH Practitioner - Physician Assistant 9335148618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

12300 McCracken Rd
Garfield Heights, OH 44125-2914

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

Hospital & facility affiliations

  • Marymount Hospital Hospital, Garfield Heights, OH, CCN 360143

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50-001272OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince May 8, 2012 Accepting new patients
Clinic Regional Physicians LLC Past Accepting new patients

Locations

36901 American Way
Avon, OH 44011
Phone (440) 930-6200

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

18901 Lake Shore Blvd
Euclid, OH 44119
Phone (216) 531-9000

12300 McCracken Rd
Garfield Hts, OH 44125
Phone (216) 581-0500

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

4110 Warrensville Center Rd
Warrensvl Hts, OH 44122
Phone (216) 491-6552

850 Columbia Rd
Ste 105
Westlake, OH 44145
Phone (440) 250-5737

Organizations & group practices 2

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 1

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669530663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74647",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441940730",
            "telephone_number": "440-879-0081",
            "fax_number": "440-879-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 WARRENSVILLE CENTER RD",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441227024",
            "telephone_number": "216-491-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVIN",
        "first_name": "MAURA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50-001272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.