NPIMap

Individual provider Active NPI

Mehrdad Tavallaee, MD

  • Internal Medicine Physician
  • Ashland, OH
National Provider Identifier
1689625634
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35079062T Issued in OH
Practice address
2021 Baney Rd S Ste a
Ashland, OH 44805-4574
Phone
(419) 289-1133
Fax
(419) 289-1132
NPI assigned
May 15, 2006
Last updated
Dec 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35079062T OH Primary

Addresses

Primary practice location

2021 Baney Rd S Ste a
Ashland, OH 44805-4574

Mailing address

2021 Baney Rd S Ste a
Ashland, OH 44805-4574
Phone (419) 289-1133

Other names 1

  • Dr. Mehrdad M. Tavallaee Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mehrdadtavallaee@uhps.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060407000079 OH Practitioner - Internal Medicine 4183633886 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1025 Ctr St
Ashland, OH 44805-4011
Phone (419) 289-9800

11100 Euclid Ave
Cleveland, OH 44106-1716

158 W Main Rd
Conneaut, OH 44030-2039

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.15 of 100Reported as apm
Quality
82.31
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy39
Upper gastrointestinal (GI) endoscopy for acid reflux17
Removal of tissue1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35079062TOHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc Current Accepting new patients
Samaritan Regional Health System Current Accepting new patients
University Primary Care Practices Inc Internal Medicine CurrentSince Jul 1, 2016 Accepting new patients
Samaritan Regional Health System CurrentSince Mar 10, 2025 Accepting new patients
University Primary Care Practices Inc CurrentSince Jul 1, 2016 Accepting new patients
University Primary Care Practices Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
University Hospitals Regional Practices LLC Internal Medicine Past Accepting new patients
Embassy Crystal Care, LLC Past Accepting new patients
The Good Shepherd Home for the Aged PastSince Jan 1, 2008 Accepting new patients
Brethren Care Village, LLC Past Accepting new patients
University Hospitals Medical Group Inc Past Accepting new patients
Good Shepherd Operator LLC Past Accepting new patients

Locations

1025 Center St
Ashland, OH 44805
Phone (419) 207-2370

2021 S Baney Rd
Ste A
Ashland, OH 44805
Phone (419) 289-1133

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

Interoperability endpoints

  • Direct secure messaging: mehrdadtavallaee@uhps.allscriptsdirect.net
  • Direct secure messaging: mtavallaee37023@ehrdirect.uhhospitals.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Huntington National BankAshland, OH, CCN 365093 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2008
Jan 1, 2008

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1689625634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 BANEY RD S STE A",
            "city": "ASHLAND",
            "state": "OH",
            "postal_code": "448054574",
            "telephone_number": "419-289-1133",
            "fax_number": "419-289-1132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 BANEY RD S STE A",
            "city": "ASHLAND",
            "state": "OH",
            "postal_code": "448054574",
            "telephone_number": "419-289-1133",
            "fax_number": "419-289-1132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVALLAEE",
        "first_name": "MEHRDAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35079062T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mehrdadtavallaee@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "2021 Baney Rd S Ste A",
            "city": "Ashland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "448054574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MEHRDAD",
            "last_name": "TAVALLAEE",
            "middle_name": "M.",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ashland, OH

Sources for this page

Verify at the official NPI Registry.