Organization Active NPI

Elite Medical Practice, LLC

  • Internal Medicine Physician
  • Rocky River, OH
National Provider Identifier
1730674037
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.082908 Issued in OH
Legal business name
ELITE MEDICAL PRACTICE, LLC
Practice address
21851 Center Ridge Rd Ste 109
Rocky River, OH 44116-3901
Phone
(440) 331-5488
Fax
(440) 331-3790
NPI assigned
Jun 28, 2018
Last updated
Jun 28, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Authorized official

Name
Dr. Emile Sabbagh, MDNPI 1831165521
Title
MD/Owner
Phone
(440) 331-5488

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.082908 OH Primary

Addresses

Primary practice location

21851 Center Ridge Rd Ste 109
Rocky River, OH 44116-3901

Mailing address

PO Box 771508
Lakewood, OH 44107-0060
Phone (440) 331-5488

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180823003106 OH Part B Supplier - Clinic/Group Practice 9931458999 Receives reassigned benefits from 11 practitioners
Practice locations: Rocky River, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2156433Elite Medical Practice, LLC21851 Center Ridge Rd, Rocky River, OH 44116Certificate of waiverOct 17, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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": "1530144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530144000000",
    "number": "1730674037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 771508",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441070060",
            "telephone_number": "440-331-5488",
            "fax_number": "440-331-3790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21851 CENTER RIDGE RD STE 109",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441163901",
            "telephone_number": "440-331-5488",
            "fax_number": "440-331-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE MEDICAL PRACTICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-28",
        "last_updated": "2018-06-28",
        "status": "A",
        "authorized_official_last_name": "SABBAGH",
        "authorized_official_first_name": "EMILE",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "440-331-5488",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.082908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky River, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.