NPIMap

Individual provider Active NPI

Jose Marcelo Llerena-Riquelme, M.D.

  • Diagnostic Radiology Physician
  • Cleveland, OH
National Provider Identifier
1811940380
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
K4488 Issued in TX
Practice address
9500 Euclid Ave
Cleveland, OH 44195-5503
Phone
(216) 448-0621
Fax
(216) 448-0220
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X K4488 TX
Diagnostic Radiology Physician 2085R0202X K4488 TX Primary

Addresses

Primary practice location

9500 Euclid Ave
Cleveland, OH 44195-5503

Mailing address

9500 Euclid Ave
Cleveland, OH 44195-5503
Phone (216) 448-0621

Other identifiers 1

IdentifierTypeStateIssuer
059227108MedicaidTX

Other names 1

  • Dr. Jose Marcelo Llerena Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040713000675 FL Practitioner - Diagnostic Radiology 3577541713 Reassigns benefits to 1 organization
I20211028002995 OH Practitioner - Diagnostic Radiology 3577541713 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
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

225 Elyria St
Lodi, OH 44254-1031
Phone (330) 948-1222

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

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-6116

Hospital & facility affiliations

  • Akron General Medical Center Hospital, Akron, OH, CCN 360027
  • Mercy Medical Center Hospital, Canton, OH, CCN 360070
  • Medina Hospital Hospital, Medina, OH, CCN 360091
  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
  • Lodi Community Hospital Hospital, Lodi, OH, CCN 361303

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K4488TXMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brevard Physician Associates, PLLC Diagnostic Radiology CurrentSince Apr 4, 2016 Accepting new patients
Clinic Medical Services Company LLC Diagnostic Radiology CurrentSince Oct 1, 2021 Accepting new patients
Wooster Clinic, LLC CurrentSince Oct 13, 2021 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Oct 13, 2021 Accepting new patients
Clinic Medical Services Company Diagnostic Radiology CurrentSince Oct 1, 2021 Accepting new patients
Consultants in Radiology PA Diagnostic Radiology Past Accepting new patients
Lsu Medical Center Past Accepting new patients
Radiology Affiliates of Central New Jersey PC Diagnostic Radiology PastSince May 25, 2021 Accepting new patients
Radiology Associates of Tampa PA Diagnostic Radiology Past Accepting new patients
Imaging Group of Delaware, PA Diagnostic Radiology Past Accepting new patients
Tower Imaging LLC Diagnostic Radiology Past Accepting new patients
West Houston Spring Branch Radiology Assoc., LLP Diagnostic Radiology Past Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G Past Accepting new patients
Innovative Radiology PA Diagnostic Radiology Past Accepting new patients

Locations

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

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

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

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

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

Organizations & group practices 14

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.

View all 14

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1811940380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441955503",
            "telephone_number": "216-448-0621",
            "fax_number": "216-448-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441955503",
            "telephone_number": "216-448-0621",
            "fax_number": "216-448-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLERENA-RIQUELME",
        "first_name": "JOSE",
        "middle_name": "MARCELO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TX",
            "license": "K4488",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "K4488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "059227108",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOSE",
            "last_name": "LLERENA",
            "middle_name": "MARCELO",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.