Individual provider Active NPI

Alexander Jakubowycz, MD

  • Emergency Medicine Physician
  • Parma, OH
National Provider Identifier
1871602052
Registry record updated Dec 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35-080546 Issued in OH
Practice address
12301 Snow Rd
Parma, OH 44130-1002
Phone
(216) 621-5600
Fax
(216) 479-5554
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35-080546 OH Primary

Addresses

Primary practice location

12301 Snow Rd
Parma, OH 44130-1002

Mailing address

1001 Lakeside Avenue
#1200
Cleveland, OH 44114
Phone (216) 479-5541

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
I20060112000004 OH Practitioner - Emergency Medicine 0547283947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-2200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-080546OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Feb 19, 2014 Accepting new patients
Physicians Emergency Services, Inc. Emergency Medicine Past Accepting new patients

Locations

525 E Market St
Akron, OH 44304
Phone (330) 375-6350

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

12301 Snow Rd
Parma Heights, OH 44130
Phone (216) 285-8810

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

Organizations & group practices 2

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 2

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197590400000",
    "number": "1871602052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 LAKESIDE AVENUE",
            "address_2": "#1200",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44114",
            "telephone_number": "216-479-5541",
            "fax_number": "216-479-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 SNOW RD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441301002",
            "telephone_number": "216-621-5600",
            "fax_number": "216-479-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAKUBOWYCZ",
        "first_name": "ALEXANDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35-080546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parma, OH

Sources for this page

Verify at the official NPI Registry.