NPIMap

Cei Physicians PSC, LLC

Organization Active NPI Ambulatory Surgical Clinic/Center · Tallmadge, OH

NPI 1972214682 · NPPES record last updated Dec 13, 2022

Key facts

NPI
1972214682
Entity type
Organization (NPI type 2)
Primary specialty
Ambulatory Surgical Clinic/Center 261QA1903X
Legal business name
CEI PHYSICIANS PSC, LLC
Practice address
518 West Ave
Tallmadge, OH 44278-2117
Phone
(330) 630-9699
Fax
(330) 633-7165
NPI assigned
Dec 13, 2022
Organization subpart
Yes
Parent organization (as reported)
CEI PHYSICIANS PSC, LLC

Authorized official

Name
Monica Cooper
Title
Provider Enrollment Supervisor
Phone
(636) 200-4393

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 8

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 155

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 155

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20230606003422 OH Part B Supplier - Ambulatory Surgical Center 0749186427 Practice locations: Tallmadge, OH

National Provider Directory

Tax ID family
Cincinnati Eye Instit S (9 organizations share this tax ID)
Part of
Cincinnati Eye Instit S

Locations

518 West Ave
Tallmadge, OH 44278
Phone (216) 630-9699

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Yes

Addresses

Primary practice location

518 West Ave
Tallmadge, OH 44278-2117

Mailing address

518 West Ave
Tallmadge, OH 44278-2117
Phone (330) 630-9699

Other names

  • Novus Clinic Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 13, 2022.

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1972214682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 WEST AVE",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442782117",
            "telephone_number": "330-630-9699",
            "fax_number": "330-633-7165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 WEST AVE",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442782117",
            "telephone_number": "330-630-9699",
            "fax_number": "330-633-7165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEI PHYSICIANS PSC, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CEI PHYSICIANS PSC, LLC",
        "enumeration_date": "2022-12-13",
        "last_updated": "2022-12-13",
        "certification_date": "2022-11-23",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT SUPERVISOR",
        "authorized_official_telephone_number": "636-200-4393"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novus Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tallmadge, OH

All providers in Tallmadge, OH · Ambulatory Surgical Clinic/Center in Ohio

Sources for this page

Verify at the official NPI Registry.