Active NPI
Gary Marmolya, M.D.
- Diagnostic Radiology Physician
- Cleveland, OH
National Provider Identifier
1942293907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 35041562
- Practice address
- 18697 Bagley Rd
Radiology Department
Cleveland, OH 44130-3417 - Phone
- (440) 816-8000
- NPI assigned
- Aug 25, 2005
- Last updated
- Jul 29, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 35041562 | OH | Primary |
Addresses
Primary practice location
18697 Bagley Rd
Radiology Department
Cleveland, OH 44130-3417
Mailing address
PO Box 567
Chagrin Falls, OH 44022-0567
Phone (216) 464-5160
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 733052 | Other | OH | BUCKEYE |
| 00000516221 | Other | OH | ANTHEM |
| 4261908 | Other | OH | AETNA |
| P00412503 | Other | OH | RAILROAD MEDICARE |
| 363808 | Other | OH | WELLCARE |
| 000000221317 | Other | OH | UNISON |
| 0750763 | Medicaid | OH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 35041562 | OH | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Bellevue Hospital | Past | Accepting new patients | |
| University Imaging Inc | Diagnostic Radiology | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Acute Care Hospital
- Bellevue, OH
- NPI 1134161623
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217289600000",
"number": "1942293907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 567",
"city": "CHAGRIN FALLS",
"state": "OH",
"postal_code": "440220567",
"telephone_number": "216-464-5160",
"fax_number": "216-464-5982"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18697 BAGLEY RD",
"address_2": "RADIOLOGY DEPARTMENT",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441303417",
"telephone_number": "440-816-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARMOLYA",
"first_name": "GARY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-25",
"last_updated": "2008-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "OH",
"license": "35041562",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BUCKEYE",
"identifier": "733052",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "00000516221",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4261908",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00412503",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "363808",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON",
"identifier": "000000221317",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0750763",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.