MEDICARE: THE CLEVELAND CLINIC FOUNDATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1013847706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CLEVELAND CLINIC FOUNDATION

Provider Business Mailing Address
First Line	:	6801 BRECKSVILLE RD
Second Line	:	STE 20, ATTN: DPC RK2-7
City	:	INDEPENDENCE
State	:	OH
Zip	:	44131-5062
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 E ROYALTON RD
Second Line	:	STE B
City	:	BROADVIEW HEIGHTS
State	:	OH
Zip	:	44147-2811
Country	:	US
Telephone Number	:	216-444-2273
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE VP CHIEF FINANCE OFFICER
Name	:	DENNIS LEE LARAWAY
Credential	:
Telephone Number	:	216-445-1343

Provider Enumeration Date	:	05/22/2026
Last Update Date	:	05/22/2026

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Directions to “THE CLEVELAND CLINIC FOUNDATION ” Practice Location

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