NPIMap

Organization Active NPI

Stella Maris, Inc.

Doing business as Stella Maris

  • Primary Care Clinic/Center
  • Cleveland, OH
National Provider Identifier
1750911376
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
STELLA MARIS, INC.
Doing business as
Stella Maris
Practice address
1320 Washington Ave
Cleveland, OH 44113-2333
Phone
(216) 727-2086
Fax
(216) 771-1563
NPI assigned
Jan 23, 2020
Last updated
Jan 23, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Authorized official

Name
Sandy Gacek
Title
Emr Administrator
Phone
(216) 727-2086

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1320 Washington Ave
Cleveland, OH 44113-2333

Mailing address

1302 Winslow Ave
Cleveland, OH 44113-2336
Phone (216) 727-2086

Other names 1

  • Stella Maris Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sandy.gacek@stellamariscleveland.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Stella Maris6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1302 Winslow Ave
Cleveland, OH 44113
Phone (216) 727-2053

NPI Registry JSON

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579737600000",
    "number": "1750911376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 WINSLOW AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441132336",
            "telephone_number": "216-727-2086",
            "fax_number": "216-771-1563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 WASHINGTON AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441132333",
            "telephone_number": "216-727-2086",
            "fax_number": "216-771-1563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STELLA MARIS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-23",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A",
        "authorized_official_last_name": "GACEK",
        "authorized_official_first_name": "SANDY",
        "authorized_official_title_or_position": "EMR ADMINISTRATOR",
        "authorized_official_telephone_number": "216-727-2086"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sandy.gacek@stellamariscleveland.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1320 Washington Ave",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441132333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Stella Maris",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.