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3401 Enterprise Pkwy Ste 110 Beachwood OH 44122-7340 | |
| (216) 448-1060 | |
| (216) 450-1031 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 3401 Enterprise Pkwy Ste 110, Beachwood, Ohio |
| Authorized Official Name and Position | Sue Ellen Rottura (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 5613238987 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1726 Cole Blvd Ste 250 Lakewood CO 80401-3262 Ph: (855) 478-1528 | 3401 Enterprise Pkwy Ste 110 Beachwood OH 44122-7340 Ph: (216) 448-1060 |
| NPI Number | 1124058920 |
|---|---|
| Provider Enumeration Date | 07/04/2006 |
| Last Update Date | 11/25/2024 |
| Medicare PECOS PAC ID | 7012995574 |
|---|---|
| Medicare Enrollment ID | O20040711000002 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124058920 | NPI | - | NPPES |
| 2519297 | Medicaid | OH | |
| 0119080 | Medicaid | OH | |
| 2624262 | Medicaid | OH | |
| 2519288 | Medicaid | OH | |
| 2485074 | Medicaid | OH | |
| 2519279 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Secondary |
| 261QI0500X | Clinic/center - Infusion Therapy | (* (Not Available)) | Primary |
| Provider Name | Matthew Schinabeck |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1285662346 PECOS PAC ID: 8729047618 Enrollment ID: I20041006001040 |
| Provider Name | Kristina Stallard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972953032 PECOS PAC ID: 8820376411 Enrollment ID: I20161102001789 |
| Provider Name | Sachin V Patel |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1942592258 PECOS PAC ID: 3577864941 Enrollment ID: I20161109001725 |
| Provider Name | Denise Paulat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649836784 PECOS PAC ID: 7416386669 Enrollment ID: I20200409000604 |
| Provider Name | Nicole Rizzardi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134704901 PECOS PAC ID: 9537568316 Enrollment ID: I20210527001188 |
| Provider Name | Olivia Szalay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982360681 PECOS PAC ID: 6204228349 Enrollment ID: I20220121001057 |
| Provider Name | Michael L Mawby |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720084114 PECOS PAC ID: 2163442914 Enrollment ID: I20220815000180 |
| Provider Name | Lee-ann Purtthipatkool |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275924169 PECOS PAC ID: 5799006532 Enrollment ID: I20230322000830 |
| Provider Name | Jacqueline A Curiston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336779958 PECOS PAC ID: 2264860345 Enrollment ID: I20230503002383 |
| Provider Name | Denise A Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265456198 PECOS PAC ID: 7113231705 Enrollment ID: I20230606000988 |
| Provider Name | Danyielle Krista Jernukian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861097263 PECOS PAC ID: 0446662431 Enrollment ID: I20240417003785 |
| Provider Name | Zeinab Berjaoui |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659972339 PECOS PAC ID: 8628463973 Enrollment ID: I20240528003674 |
American Medical Legal Consultants Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 25450 Twickenham Dr, Beachwood, OH 44122 Phone: 216-464-5880 | |
Fatuma Midamba Md Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3619 Park East Dr, 205 S, Beachwood, OH 44122 Phone: 216-591-0942 Fax: 440-834-1902 | |
Everside Health, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 25700 Science Park Dr Ste 120, Beachwood, OH 44122 Phone: 216-672-0211 | |
Impact Physician Group, Ohio Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 23333 Harvard Rd, Beachwood, OH 44122 Phone: 216-593-2200 | |