Active NPI
Stephen S Jurak, MD
- Pediatrics Physician
- Westlake, OH
National Provider Identifier
1952366494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 35045621
- Practice address
- 2001 Crocker Rd Ste 600
Westlake, OH 44145-6972 - Phone
- (440) 871-5100
- Fax
- (440) 871-5610
- NPI assigned
- Apr 18, 2006
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 35045621 | OH | Primary |
Addresses
Primary practice location
2001 Crocker Rd Ste 600
Westlake, OH 44145-6972
Mailing address
PO Box 8792
Belfast, ME 04915-8792
Phone (440) 871-5100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0164692 | 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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35045621 | OH | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300406400000",
"number": "1952366494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8792",
"city": "BELFAST",
"state": "ME",
"postal_code": "049158792",
"telephone_number": "440-871-5100",
"fax_number": "440-871-5610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 CROCKER RD STE 600",
"city": "WESTLAKE",
"state": "OH",
"postal_code": "441456972",
"telephone_number": "440-871-5100",
"fax_number": "440-871-5610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JURAK",
"first_name": "STEPHEN",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-18",
"last_updated": "2011-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OH",
"license": "35045621",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0164692",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Westlake, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.