Individual provider Active NPI

Lori A Mahajan, M.D.

  • Pediatric Gastroenterology Physician
  • Cleveland, OH
National Provider Identifier
1780648444
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
35067009M Issued in OH
Practice address
9500 Euclid Ave # R3
Cleveland, OH 44195-0001
Phone
(216) 445-1572
Fax
(216) 444-2974
NPI assigned
Apr 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35067009M OH
Pediatric Gastroenterology Physician 2080P0206X 35067009M OH Primary

Addresses

Primary practice location

9500 Euclid Ave # R3
Cleveland, OH 44195-0001

Mailing address

9500 Euclid Ave # R3
Cleveland, OH 44195-0001
Phone (216) 445-1572

Other identifiers 1

IdentifierTypeStateIssuer
2270162MedicaidOH

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
I20041208000286 OH Practitioner - Pediatric MedicinePractitioner - Gastroenterology 2769448000 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35067009MOHMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System Pediatrics CurrentSince Aug 13, 2014 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Aug 13, 2010 Accepting new patients
The Metrohealth System CurrentSince Aug 13, 2014 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

551 Washington St
Chagrin Falls, OH 44022
Phone (440) 893-9393

9500 Euclid Ave
#A111
Cleveland, OH 44195
Phone (216) 444-2344

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

9500 Euclid Ave
#R3
Cleveland, OH 44195

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

6000 W Creek Rd
Ste 10
Independence, OH 44131
Phone (216) 986-1256

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Interoperability endpoints

  • Direct secure messaging: lmahajan4951@direct.ccf.org

Organizations & group practices 5

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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1780648444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE # R3",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-445-1572",
            "fax_number": "216-444-2974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE # R3",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-445-1572",
            "fax_number": "216-444-2974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAJAN",
        "first_name": "LORI",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35067009M",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "OH",
            "license": "35067009M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2270162",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.