NPIMap

Organization Active NPI

Clinic Medical Services Company

Doing business as Cleveland Clinic Star Imaging

  • Diagnostic Radiology Physician
  • Niles, OH
National Provider Identifier
1992963680
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
1229IC Issued in OH
Legal business name
CLINIC MEDICAL SERVICES COMPANY
Doing business as
Cleveland Clinic Star Imaging
Practice address
652 Youngstown Warren Rd
Niles, OH 44446-4356
Phone
(330) 505-2280
Fax
(330) 505-2286
NPI assigned
May 29, 2008
Last updated
May 29, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
CLEVELAND CLINIC FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 29, 2008

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

Authorized official

Name
Ms. Diane Marie Maiorana
Title
Managed Care Manager
Phone
(216) 642-8165

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 1229IC OH Primary

Addresses

Primary practice location

652 Youngstown Warren Rd
Niles, OH 44446-4356

Mailing address

6100 W Creek Rd
Suite 35
Independence, OH 44131-2133
Phone (216) 642-8165

Other names 1

  • Cleveland Clinic Star Imaging Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060417000268 OH Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 5698674653 1 other NPI on this enrollment
Practice locations: Niles, OH

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Clinical Medical Company7 organizations share this tax ID, including this one
Part of
Dept of Immunopathology

Other organizations with this tax ID 6

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 45

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.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1992963680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 W CREEK RD",
            "address_2": "SUITE 35",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312133",
            "telephone_number": "216-642-8165",
            "fax_number": "216-642-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "652 YOUNGSTOWN WARREN RD",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444464356",
            "telephone_number": "330-505-2280",
            "fax_number": "330-505-2286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINIC MEDICAL SERVICES COMPANY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLEVELAND CLINIC FOUNDATION",
        "enumeration_date": "2008-05-29",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "MAIORANA",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "MANAGED CARE MANAGER",
        "authorized_official_telephone_number": "216-642-8165",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "1229IC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cleveland Clinic Star Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Niles, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.