Active NPI
Partners Physician Group
- Internal Medicine Physician
- Fairlawn, OH
National Provider Identifier
1891987202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 35-049020
- Legal business name
- PARTNERS PHYSICIAN GROUP
- Practice address
- 71 Baker Blvd
Ste. 101
Fairlawn, OH 44333-3639 - Phone
- (330) 836-2254
- NPI assigned
- Aug 10, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Daniel Taillard
- Title
- Director Finance Business Operation
- Phone
- (330) 344-6095
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35-049020 | OH | Primary |
Addresses
Primary practice location
71 Baker Blvd
Ste. 101
Fairlawn, OH 44333-3639
Mailing address
4125 Medina Rd
Akron, OH 44333-2483
Phone (330) 665-8224
Other names 1
- Benjamin Goldman, MD
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031202000183 | OH | Part B Supplier - Clinic/Group Practice | 4183529340 |
Receives reassigned benefits from 724 practitioners 7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
Other NPIs on the same Medicare enrollment 7
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Public Health & General Preventive Medicine Physician
- Akron, OH
- NPI 1164814414
O20031202000183
-
- Internal Medicine Physician
- Cuyahoga Falls, OH
- NPI 1578754198
O20031202000183
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186704000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1186704000000",
"number": "1891987202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4125 MEDINA RD",
"city": "AKRON",
"state": "OH",
"postal_code": "443332483",
"telephone_number": "330-665-8224",
"fax_number": "330-665-8321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "71 BAKER BLVD",
"address_2": "STE. 101",
"city": "FAIRLAWN",
"state": "OH",
"postal_code": "443333639",
"telephone_number": "330-836-2254"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PARTNERS PHYSICIAN GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2007-08-10",
"last_updated": "2007-08-10",
"status": "A",
"authorized_official_last_name": "TAILLARD",
"authorized_official_first_name": "DANIEL",
"authorized_official_title_or_position": "DIRECTOR FINANCE BUSINESS OPERATION",
"authorized_official_telephone_number": "330-344-6095"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "OH",
"license": "35-049020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Benjamin Goldman, MD",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Fairlawn, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.