Active NPI
Maurice Ae Soremekun, M.D.
- Obstetrics & Gynecology Physician
- Beachwood, OH
National Provider Identifier
1770670382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 35042586
- Practice address
- 3619 Park East Dr
#311 South Building
Beachwood, OH 44122 - Phone
- (216) 464-9154
- NPI assigned
- Oct 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 35042586 | OH | Primary |
Addresses
Primary practice location
3619 Park East Dr
#311 South Building
Beachwood, OH 44122
Mailing address
P.O. Box 367
Chesterland, OH 44026
Phone (216) 464-9154
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0930505 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35042586 | OH | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574121600000",
"number": "1770670382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 367",
"city": "CHESTERLAND",
"state": "OH",
"postal_code": "44026",
"telephone_number": "216-464-9154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3619 PARK EAST DR",
"address_2": "#311 SOUTH BUILDING",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "44122",
"telephone_number": "216-464-9154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOREMEKUN",
"first_name": "MAURICE",
"middle_name": "AE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-06",
"last_updated": "2019-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "OH",
"license": "35042586",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0930505",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beachwood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.