Khalil Azem, MD is a medicare enrolled "Otolaryngology" physician in Willoughby, Ohio. His current practice location is
36100 Euclid Ave, Ste 350, Willoughby, Ohio. You can reach out to his office (for appointments etc.) via phone at
(440) 942-9308.
Khalil Azem is licensed to practice in Ohio (license number 054514) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1508859497.
Physician's Profile
| Full Name | Khalil Azem |
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| Gender | Male |
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| Speciality | Otolaryngology |
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| Location | 36100 Euclid Ave, Willoughby, Ohio |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1508859497
- Provider Enumeration Date: 08/25/2005
- Last Update Date: 10/04/2010
Medicare PECOS Information:
- PECOS PAC ID: 9931162070
- Enrollment ID: I20041110000100
Medical Identifiers
Medical identifiers for Khalil Azem such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1508859497 | NPI | - | NPPES |
| 000000131755 | Other | OH | BLUE CROSS BLUE SHIELD |
| 0652575 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Y00000X | Otolaryngology | 054514 (Ohio) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Khalil Azem allows following entities to bill medicare on his behalf.
| Entity Name | The Cleveland Clinic Foundation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1679525919
PECOS PAC ID: 1850203555
Enrollment ID: O20031103000049 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Khalil Azem is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Khalil Azem, MD
36100 Euclid Ave, Ste 350,
Willoughby, OH 44094-4456
Ph: (440) 942-9308 | Khalil Azem, MD
36100 Euclid Ave, Ste 350,
Willoughby, OH 44094-4456
Ph: (440) 942-9308 |
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