NPIMap

Organization Active NPI

Marymount Hospital, Inc.

  • Anatomic Pathology & Clinical Pathology Physician
  • Garfield Heights, OH
National Provider Identifier
1720031131
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
MARYMOUNT HOSPITAL, INC.
Practice address
12300 McCracken Rd
Garfield Heights, OH 44125-2914
Phone
(216) 587-8686
Fax
(216) 587-8274
NPI assigned
May 18, 2006
Last updated
Aug 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Authorized official

Name
Dennis Laraway
Title
Executive VP Chief Finance Officer
Phone
(216) 445-1343

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

12300 McCracken Rd
Garfield Heights, OH 44125-2914

Mailing address

12300 McCracken Rd
Garfield HTS, OH 44125-2914
Phone (216) 587-8146

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031217000026 OH Part B Supplier - Clinic/Group Practice 6507763661 Receives reassigned benefits from 27 practitioners
1 other NPI on this enrollment
Practice locations: Garfield Heights, OH; Garfield HTS, OH

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 34

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.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756080000000",
    "number": "1720031131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12300 MCCRACKEN RD",
            "city": "GARFIELD HTS",
            "state": "OH",
            "postal_code": "441252914",
            "telephone_number": "216-587-8146",
            "fax_number": "216-587-8831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12300 MCCRACKEN RD",
            "city": "GARFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441252914",
            "telephone_number": "216-587-8686",
            "fax_number": "216-587-8274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYMOUNT HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A",
        "authorized_official_last_name": "LARAWAY",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "EXECUTIVE VP CHIEF FINANCE OFFICER",
        "authorized_official_telephone_number": "216-445-1343"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garfield Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; 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.