Gregory Bourdakos, M.D.

Primary specialty

Critical Care Medicine (Anesthesiology) PhysicianTaxonomy code 207LC0200X

License

35064702 Issued in OH

Practice address

9500 Euclid Ave
Cleveland, OH 44195-0001

Phone

(800) 223-2273

NPI assigned

Apr 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Marios Gregory Bourdakos Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: gbourdakos49908@direct.ccf.org

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.

• Euclid Hospital Cleveland Clinic Health System

  • General Acute Care Hospital
  • Euclid, OH
  • NPI 1457403016
  NPD

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410912000000",
    "number": "1699738583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 W CREEK RD",
            "address_2": "SUITE 10",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312139",
            "telephone_number": "800-223-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "800-223-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURDAKOS",
        "first_name": "GREGORY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2014-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OH",
            "license": "35064702B",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "OH",
            "license": "35064702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2181571",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIOS",
            "last_name": "BOURDAKOS",
            "middle_name": "GREGORY",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mariah Boumeester
• Melissa Boumitri
• Veronica Renee Bounds
• Jennica Phenide Bouquet
• Demetrios Bourdakos, MD
• Toby Bourisseau, CNS
• Lynn Bourque, LSW
• Nicholas Bourque
• Rany Bous, BDS
• Lea Bouserhal

• Critical Care Medicine (Anesthesiology) Physician in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Critical Care Medicine (Anesthesiology) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; 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.