Individual provider Active NPI

Ann M Bacevice, MD

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Cleveland, OH
National Provider Identifier
1760414593
Registry record updated Jun 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
35080264 Issued in OH
Practice address
11100 Euclid Avenue
Cleveland, OH 44106
Phone
(216) 844-7700
Fax
(216) 286-6341
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 35080264 OH Primary

Addresses

Primary practice location

11100 Euclid Avenue
Cleveland, OH 44106

Mailing address

24701 Euclid Ave
3Rd Floor
Euclid, OH 44117-1714

Other identifiers 8

IdentifierTypeStateIssuer
1021123120001OtherPAPA MEDICAID
750458OtherOHBUCKEYE
000000527950OtherOHANTHEM
363418OtherOHWELLCARE
P00411237OtherOHRAILROAD MEDICARE
2350263MedicaidOH
000000221286OtherOHUNISON
7515338OtherOHAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040722000266 OH Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 3971583725 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35080264OHMDPediatric Emergency Medicine (Pediatrics) Physician

Interoperability endpoints

  • Direct secure messaging: abacevice36121@ehrdirect.uhhospitals.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309392000000",
    "number": "1760414593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24701 EUCLID AVE",
            "address_2": "3RD FLOOR",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441171714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVENUE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44106",
            "telephone_number": "216-844-7700",
            "fax_number": "216-286-6341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACEVICE",
        "first_name": "ANN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2011-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "OH",
            "license": "35080264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA MEDICAID",
            "identifier": "1021123120001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEYE",
            "identifier": "750458",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000527950",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "363418",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00411237",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2350263",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "000000221286",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7515338",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.