Individual provider Active NPI

Melvin Jay Chavinson, M.D.

  • Psychiatry Physician
  • Mentor, OH
National Provider Identifier
1801925748
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35031360 Issued in OH
Practice address
7350 Palisades Pkwy
Mentor, OH 44060-5302
Phone
(440) 918-1000
Fax
(440) 918-1029
NPI assigned
Mar 5, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35031360 OH Primary

Addresses

Primary practice location

7350 Palisades Pkwy
Mentor, OH 44060-5302

Mailing address

21169 Claythorne Rd
Shaker Heights, OH 44122-1967
Phone (216) 321-9798

Other identifiers 2

IdentifierTypeStateIssuer
0268848MedicaidOH
000000224368OtherOHANTHEM BLUE CROSS

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

LicenseStateTypeSpecialty
11318CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Services CurrentSince Mar 20, 2022 Accepting new patients
Pathways Inc Past Accepting new patients
Pathways Inc. Past Accepting new patients

Locations

1555 Parkmoor Ave
San Jose, CA 95128
Phone (408) 282-0402

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801925748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21169 CLAYTHORNE RD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441221967",
            "telephone_number": "216-321-9798",
            "fax_number": "440-918-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7350 PALISADES PKWY",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440605302",
            "telephone_number": "440-918-1000",
            "fax_number": "440-918-1029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVINSON",
        "first_name": "MELVIN",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35031360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0268848",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "000000224368",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.