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1013942101

NPI Code Detail

MEDICARE: MAYFIELD CLINIC INC

MEDICARE: MAYFIELD CLINIC INC

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	207LP2900X	Pain Medicine (Anesthesiology) Physician
2	207L00000X	Anesthesiology Physician
3	207RP1001X	Pulmonary Disease Physician
4	207XS0117X	Orthopaedic Surgery of the Spine Physician
5	208100000X	Physical Medicine & Rehabilitation Physician
6	2081P0004X	Spinal Cord Injury Medicine Physician
7	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician
8	2085N0700X	Neuroradiology Physician
9	2085R0202X	Diagnostic Radiology Physician
10	225100000X	Physical Therapist
11	363A00000X	Physician Assistant
12	363AS0400X	Surgical Physician Assistant
13	363L00000X	Nurse Practitioner
14	363LA2100X	Acute Care Nurse Practitioner
15	207T00000X	Neurological Surgery Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CC0892	OTHER	OH	RAILROAD MEDICARE
6	CF9178	OTHER	KY	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013942101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAYFIELD CLINIC INC

Provider Business Mailing Address
First Line	:	PO BOX 643398
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45264-3398
Country	:	US
Telephone Number	:	513-221-1100
Fax Number	:	513-569-5279

Provider Business Practice Location Address
First Line	:	3825 EDWARDS RD STE 300
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45209-1288
Country	:	US
Telephone Number	:	513-221-1100
Fax Number	:	513-569-5279

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. MICHAEL J RADOMSKI
Credential	:	VP
Telephone Number	:	513-221-1100

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	07/10/2024

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Directions to “MAYFIELD CLINIC INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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