Individual provider Active NPI

David J. Fishman, M.D.

  • Internal Medicine Physician
  • Highland HTS, OH
National Provider Identifier
1790774339
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
039578 Issued in OH
Practice address
410 Medway Rd
Highland HTS, OH 44143-3725
Phone
(169) 784-5432
Fax
(404) 219-8464
NPI assigned
Oct 17, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 039578 OH
Internal Medicine Physician 207R00000X 039578 OH Primary

Addresses

Primary practice location

410 Medway Rd
Highland HTS, OH 44143-3725

Mailing address

410 Medway Rd
Highland HTS, OH 44143-3725
Phone (216) 978-4543

Other identifiers 2

IdentifierTypeStateIssuer
0215903MedicaidOH
000000136594OtherOHANTHEM

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
I20111119000038 OH Practitioner - Internal Medicine 4486791803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Perelman School of Med at the University of Pennsylvania, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ameriwound LLCGroup PAC ID 0345498853, 8 clinicians

Practice addresses (Care Compare)

14095 E Ctr St
Burton, OH 44021-9651
Phone (216) 273-9800

Merit-based Incentive Payment System (MIPS)

Final score
99.01 of 100Reported as group
Quality
78.82
Promoting interoperability
100
Improvement activities
40
Cost
84.55

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue40
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
039578OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ameriwound LLC CurrentSince Jan 2, 2019 Accepting new patients

Locations

1211 W Market St
Akron, OH 44313
Phone (330) 867-8530

14803 Holland Rd
Brook Park, OH 44142
Phone (216) 267-0555

14095 E Center St
Burton, OH 44021
Phone (440) 834-1084

5005 Higbee Ave NW
Canton, OH 44718
Phone (330) 259-1145

7025 Clovernook Ave
Cincinnati, OH 45231
Phone (513) 605-4000

16101 Euclid Beach Blvd
Cleveland, OH 44110
Phone (216) 486-2300

1835 Belmore Rd
East Cleveland, OH 44112
Phone (216) 268-3600

120 Brookmont Rd
Fairlawn, OH 44333
Phone (330) 666-4545

19900 Clare Ave
Maple Heights, OH 44137
Phone (216) 623-3343

5800 Landerbrook Dr
Ste 220
Mayfield Hts, OH 44124

6150 Parkland Blvd
Ste 225
Mayfield Hts, OH 44124

23225 Lorain Rd
North Olmsted, OH 44070
Phone (440) 779-6900

51 E 4th St
The Plains, OH 45780
Phone (740) 797-4561

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": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1790774339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 MEDWAY RD",
            "city": "HIGHLAND HTS",
            "state": "OH",
            "postal_code": "441433725",
            "telephone_number": "216-978-4543",
            "fax_number": "440-421-9846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 MEDWAY RD",
            "city": "HIGHLAND HTS",
            "state": "OH",
            "postal_code": "441433725",
            "telephone_number": "169-784-5432",
            "fax_number": "404-219-8464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHMAN",
        "first_name": "DAVID",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "039578",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "039578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0215903",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000136594",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland HTS, OH

Sources for this page

Verify at the official NPI Registry.