Individual provider Active NPI

Ioan Florin Susoiu Tcaciuc, M.D.

  • Internal Medicine Physician
  • Cleveland, OH
National Provider Identifier
1770710378
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35-092905 Issued in OH
Practice address
17876 Saint Clair Ave
Cleveland, OH 44110-2602
Phone
(216) 383-2222
Fax
(216) 298-0241
NPI assigned
Jun 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 35-092905 OH
Internal Medicine Physician 207R00000X 35-092905 OH Primary

Addresses

Primary practice location

17876 Saint Clair Ave
Cleveland, OH 44110-2602

Mailing address

17876 Saint Clair Ave
Cleveland, OH 44110-2602
Phone (216) 383-2222

Other identifiers 1

IdentifierTypeStateIssuer
2962254MedicaidOH

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
I20090904000544 OH Practitioner - Hospice/Palliative CarePractitioner - Internal Medicine 7315092814 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-092905OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospice of the Western Reserve at University Hospitals, LLC CurrentSince Apr 2, 2024 Accepting new patients

Locations

17876 Saint Clair Ave
Cleveland, OH 44110
Phone (216) 383-2222

17876 Saint Clair Ave
Ste 102
Cleveland, OH 44110
Phone (216) 701-0736

Organizations & group practices 2

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": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1770710378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17876 SAINT CLAIR AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441102602",
            "telephone_number": "216-383-2222",
            "fax_number": "216-298-0241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17876 SAINT CLAIR AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441102602",
            "telephone_number": "216-383-2222",
            "fax_number": "216-298-0241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSOIU TCACIUC",
        "first_name": "IOAN FLORIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-22",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "OH",
            "license": "35-092905",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-092905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2962254",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.