NPIMap

Organization Active NPI

St Vincent Charity Medical Center

  • General Acute Care Hospital
  • Cleveland, OH
National Provider Identifier
1710951801
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
ST VINCENT CHARITY MEDICAL CENTER
Doing business as
St Vincent Charity Medical Center
Practice address
2351 E 22ND St
Cleveland, OH 44115-3111
Phone
(216) 861-6200
Fax
(440) 746-3405
NPI assigned
Feb 15, 2006
Last updated
Nov 17, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Authorized official

Name
Mr. John Rusnaczyk
Title
Senior VP & Cfo
Phone
(216) 363-7718

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

2351 E 22ND St
Cleveland, OH 44115-3111

Mailing address

6935 Treeline Dr
Suite J
Brecksville, OH 44141-3393
Phone (440) 746-3401

Other identifiers 15

IdentifierTypeStateIssuer
341893452005OtherOHMEDICAL MUTUAL OF OHIO
2137410001OtherOHCARESOURCE
34189342007OtherOHMEDICAL MUTUAL OF OHIO CD
7649709MedicaidOH
615124400OtherDEPARTMENT OF LABOR
0009438OtherAETNA US HEALTHCARE
304978OtherBLACK LUNG
5000072OtherUNITED HEALTHCARE
3009523MedicaidOH
34189345202OtherOHBUREAU WORKERS' COMPENSAT
000000157500OtherANTHEM
341893452001OtherCHAMPUS
7649709OtherOHPEOPLES HEALTH PLAN
81312OtherOHQUALCHOICE
016984000OtherMAGELLAN BEHAVIORAL HLTH

Other names 1

  • St Vincent Charity Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100626000223 OH Part B Supplier - Clinic/Group Practice 2860535978 Receives reassigned benefits from 16 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cleveland, OH

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member organizations 8

Organizations listed as members of this organization in the National Provider Directory.

Locations

2475 E 22nd St
Fl 4
Cleveland, OH 44115
Phone (216) 363-2570

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321488000000",
    "number": "1710951801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6935 TREELINE DR",
            "address_2": "SUITE J",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441413393",
            "telephone_number": "440-746-3401",
            "fax_number": "440-746-3405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 E 22ND ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441153111",
            "telephone_number": "216-861-6200",
            "fax_number": "440-746-3405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST VINCENT CHARITY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-15",
        "last_updated": "2011-11-17",
        "status": "A",
        "authorized_official_last_name": "RUSNACZYK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SENIOR VP & CFO",
        "authorized_official_telephone_number": "216-363-7718",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL OF OHIO",
            "identifier": "341893452005",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "2137410001",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL OF OHIO CD",
            "identifier": "34189342007",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7649709",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR",
            "identifier": "615124400",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "0009438",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "304978",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "5000072",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3009523",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUREAU WORKERS' COMPENSAT",
            "identifier": "34189345202",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000157500",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "341893452001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEOPLES HEALTH PLAN",
            "identifier": "7649709",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "81312",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BEHAVIORAL HLTH",
            "identifier": "016984000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Vincent Charity Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.