NPIMap

Organization Active NPI

North Shore Anesthesia Limited, LLC

  • Anesthesiology Physician
  • Westlake, OH
National Provider Identifier
1730460205
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
NORTH SHORE ANESTHESIA LIMITED, LLC
Practice address
850 Columbia Rd Ste 200
Westlake, OH 44145-7215
Phone
(440) 808-1212
Fax
(440) 808-2060
NPI assigned
Aug 29, 2011
Last updated
Jan 23, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTH SHORE GASTROENTEROLOGY, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Authorized official

Name
Dr. Mousab I Tabbaa, MDNPI 1184642050
Title
President
Phone
(440) 808-1212

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

850 Columbia Rd Ste 200
Westlake, OH 44145-7215

Mailing address

850 Columbia Rd
Suite 200
Westlake, OH 44145-1493
Phone (440) 808-1212

Other practice location 1

7580 Northcliff Ave Ste 1000
Brooklyn, OH 44144-3271
Phone (440) 808-1212

Other identifiers 2

IdentifierTypeStateIssuer
DS6414OtherOHMEDICARE RAILROAD
0061881MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120130000886 OH Part B Supplier - Clinic/Group Practice 1759554074 Receives reassigned benefits from 24 practitioners
Practice locations: Brooklyn, OH; Westlake, OH

National Provider Directory

National Provider Directory
Part of
North Shore Gastroenterology Inc

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 28

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 28

NPI Registry JSON

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

{
    "created_epoch": "1314576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705968000000",
    "number": "1730460205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 COLUMBIA RD",
            "address_2": "SUITE 200",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441451493",
            "telephone_number": "440-808-1212",
            "fax_number": "440-808-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 COLUMBIA RD STE 200",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441457215",
            "telephone_number": "440-808-1212",
            "fax_number": "440-808-2060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7580 Northcliff Ave Ste 1000",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "OH",
            "postal_code": "441443271",
            "country_code": "US",
            "telephone_number": "440-808-1212",
            "fax_number": "440-808-2060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTH SHORE ANESTHESIA LIMITED, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH SHORE GASTROENTEROLOGY, INC",
        "enumeration_date": "2011-08-29",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A",
        "authorized_official_last_name": "TABBAA",
        "authorized_official_first_name": "MOUSAB",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-808-1212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DS6414",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0061881",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.