NPIMap

Organization Active NPI

Western Reserve Plastic Surgery

  • Plastic Surgery Physician
  • Independence, OH
National Provider Identifier
1912086240
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
35051876P Issued in OH
Legal business name
WESTERN RESERVE PLASTIC SURGERY
Practice address
5005 Rockside Rd
#640
Independence, OH 44131-2194
Phone
(216) 328-0800
Fax
(330) 328-1860
NPI assigned
Nov 6, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
George J Picha, MDNPI 1326052093
Title
Ceo
Phone
(216) 328-0800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 35051876P OH Primary

Addresses

Primary practice location

5005 Rockside Rd
#640
Independence, OH 44131-2194

Mailing address

5005 Rockside Rd
#640
Independence, OH 44131-2194
Phone (216) 328-0800

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912086240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 ROCKSIDE RD",
            "address_2": "#640",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312194",
            "telephone_number": "216-328-0800",
            "fax_number": "330-328-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 ROCKSIDE RD",
            "address_2": "#640",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312194",
            "telephone_number": "216-328-0800",
            "fax_number": "330-328-1860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN RESERVE PLASTIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PICHA",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "216-328-0800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "OH",
            "license": "35051876P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.