MEDICARE: CLEVELAND CENTER FOR DIGESTIVE

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	261QC1800X	Corporate Health Clinic/Center	0065AS	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00304788	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000389849	OTHER	OH	ANTHEM BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	7316076	OTHER	OH	AETNA
4	000000389849	OTHER	OH	ANTHEM- BLUE CROSS & BLUE SHIELD

General Provider Information

NPI Number	:	1013967025
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEVELAND CENTER FOR DIGESTIVE

Provider Business Mailing Address
First Line	:	3700 PARK EAST DR
Second Line	:	SUITE 100
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-4339
Country	:	US
Telephone Number	:	216-593-7700
Fax Number	:	216-593-7190

Provider Business Practice Location Address
First Line	:	3700 PARK EAST DR
Second Line	:	SUITE 100
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-4339
Country	:	US
Telephone Number	:	216-593-7700
Fax Number	:	216-593-7190

Authorized Official
Title or Position	:	CIO/ADMINISTRATOR
Name	:	MR. JAMES J ANDRASSY
Credential	:
Telephone Number	:	216-593-7502

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	11/04/2014

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Directions to “CLEVELAND CENTER FOR DIGESTIVE ” Practice Location

Language	Start Address	Practice Location

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