Individual provider Active NPI

Christine L Jellis, M.D. PHD

  • Cardiovascular Disease Physician
  • Cleveland, OH
National Provider Identifier
1790126688
Registry record updated Dec 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
57.022325 Issued in OH
Practice address
J1-5 9500 Euclid Ave
Cleveland, OH 44195-0001
Phone
(216) 445-6312
Fax
(216) 445-6150
NPI assigned
Jul 9, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 57.022325 OH Primary

Addresses

Primary practice location

J1-5 9500 Euclid Ave
Cleveland, OH 44195-0001

Mailing address

J1-5 9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 445-6312

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
I20150818004726 OH Practitioner - Cardiovascular Disease (Cardiology) 9335454461 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clinic Medical Services CompanyGroup PAC ID 5698674653, 201 clinicians
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

1000 E Washington St
Medina, OH 44256-2170
Phone (330) 721-5117

126 /2 N Broadway St
Sugarcreek, OH 44681-9384
Phone (330) 852-0704

2420 Lake Ave
Ashtabula, OH 44004-4954
Phone (440) 997-2262

2550 Som Ctr Rd
Willoughby Hills, OH 44094-9655
Phone (440) 943-2500

33100 Cleveland Clinic Blvd
Avon, OH 44011-1390
Phone (440) 695-4000

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57.022325OHMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinic Medical Services Company LLC CurrentSince Jan 23, 2017 Accepting new patients
Clinic Medical Services Company CurrentSince Jan 23, 2017 Accepting new patients
Wooster Clinic, LLC CurrentSince May 29, 2017 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Jul 8, 2015 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

9500 Euclid Ave
#J15
Cleveland, OH 44195
Phone (216) 444-3408

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

1740 Cleveland Rd
Wooster, OH 44691
Phone (330) 287-4500

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450137600000",
    "number": "1790126688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "J1-5 9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-445-6312",
            "fax_number": "216-445-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "J1-5 9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-445-6312",
            "fax_number": "216-445-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JELLIS",
        "first_name": "CHRISTINE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D. PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-09",
        "last_updated": "2015-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "57.022325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.