Organization Active NPI

Kourosh Saghafi DO Inc

  • Geriatric Medicine (Internal Medicine) Physician
  • Parma, OH
National Provider Identifier
1750596102
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
34006341 Issued in OH
Legal business name
KOUROSH SAGHAFI DO INC
Practice address
6681 Ridge Road
Suite 300
Parma, OH 44129-5713
Phone
(440) 842-1295
Fax
(216) 351-3619
NPI assigned
May 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Authorized official

Name
Mr. James Saghafi
Title
Office Manager
Phone
(216) 702-0360

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X 34006341 OH Primary

Addresses

Primary practice location

6681 Ridge Road
Suite 300
Parma, OH 44129-5713

Mailing address

6681 Ridge Road
Suite 300
Parma, OH 44129-5713
Phone (216) 702-0360

Other identifiers 1

IdentifierTypeStateIssuer
2785893MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090819000487 OH Part B Supplier - Clinic/Group Practice 7618947490 Receives reassigned benefits from 1 practitioner
Practice locations: Parma Heights, OH; Parma, OH; Middleburg Heights, OH; Garfield Heights, OH; Cleveland, OH; Broadview HTS, OH

National Provider Directory

National Provider Directory

Locations

1201 Akins Rd
Broadview Hts, OH 44147
Phone (440) 457-2900

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209513600000",
    "number": "1750596102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6681 RIDGE ROAD",
            "address_2": "SUITE 300",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441295713",
            "telephone_number": "216-702-0360",
            "fax_number": "216-351-3619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6681 RIDGE ROAD",
            "address_2": "SUITE 300",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441295713",
            "telephone_number": "440-842-1295",
            "fax_number": "216-351-3619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOUROSH SAGHAFI DO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2008-04-30",
        "status": "A",
        "authorized_official_last_name": "SAGHAFI",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "216-702-0360",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "OH",
            "license": "34006341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2785893",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parma, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; 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.