Active NPI
Hisham Bazin
- Dentist
- Cleveland, OH
National Provider Identifier
1962942953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- RES.003796
- Practice address
- 2500 Metrohealth Drive
Cleveland, OH 44109-1998 - Phone
- (216) 778-4406
- NPI assigned
- Feb 24, 2017
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | RES.003796 | OH | Primary |
Addresses
Primary practice location
2500 Metrohealth Drive
Cleveland, OH 44109-1998
Mailing address
201 W 106TH St Apt 11
New York, NY 10025-3675
Phone (267) 777-3591
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170816003891 | OH | Order and Referring Only - Dentist | 4183996796 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RES.003796 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491696000000",
"number": "1962942953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 W 106TH ST APT 11",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100253675",
"telephone_number": "267-777-3591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 METROHEALTH DRIVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441091998",
"telephone_number": "216-778-4406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAZIN",
"first_name": "HISHAM",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-02-24",
"last_updated": "2017-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "RES.003796",
"primary": true
}
],
"identifiers": [],
"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 Apr 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.