Cardiovascular Medicine of Cleveland, LLC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

35-071087 Issued in OH

Legal business name

CARDIOVASCULAR MEDICINE OF CLEVELAND, LLC

Practice address

21500 Lorain Rd
Fairview Park, OH 44126-3302

Phone

(440) 356-6666

Fax

(440) 356-6651

NPI assigned

Sep 1, 2006

Last updated

Sep 5, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Basel Z Moussa, M.D.NPI 1467563429

Title

Owner

Phone

(440) 356-6666

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Practitioners 1

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.

• Basel Moussa, MD

  • Specialist
  • Fairview Park, OH
  • NPI 1467563429
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693872000000",
    "number": "1750483848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 450615",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441450611",
            "telephone_number": "440-356-6666",
            "fax_number": "440-356-6651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21500 LORAIN RD",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441263302",
            "telephone_number": "440-356-6666",
            "fax_number": "440-356-6651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR MEDICINE OF CLEVELAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A",
        "authorized_official_last_name": "MOUSSA",
        "authorized_official_first_name": "BASEL",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-356-6666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35-071087",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OH",
            "license": "35-071087",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "OH",
            "license": "35-071087",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2707495",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cardiovascular Disease Physician in Fairview Park, OH
• Providers in Fairview Park, OH by specialty
• Cardiovascular Disease Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.