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OUTREACH PROFESSIONAL SERVICES INC NPI 1134119829


NPI Information

NPI: 1134119829
Provider Name: OUTREACH PROFESSIONAL SERVICES INC

Doing Business As: ST VINCENT MEDICAL GROUP

Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 36D0337261

Address:
2351 E 22ND ST
CLEVELAND, OH
ZIP 44115
Phone: (216) 363-2730
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OUTREACH PROFESSIONAL SERVICES INC is an internal medicine in Cleveland, OH. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. OUTREACH PROFESSIONAL SERVICES INC NPI is 1134119829. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As St Vincent Medical Group.

The provider's business location address is:

2351 E 22ND ST
CLEVELAND, OH
ZIP 44115-111
Phone: (216) 363-2730

The provider's authorized official is John Rusnaczyk .
The authorized official title is Senior Vice President & Cfo and has the following contact phone number (216) 363-7718.

The CLIA number assigned to this NPI record is 36D0337261 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/25/2005 and was last updated on 1/13/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207V00000XObstetrics & GynecologyNo
2207X00000XOrthopaedic SurgeryNo
3208000000XPediatricsNo
4207Q00000XFamily MedicineNo
5207QG0300XFamily MedicineGeriatric MedicineNo
62084P0800XPsychiatry & NeurologyPsychiatryNo
7207RR0500XInternal MedicineRheumatologyNo
8207RX0202XInternal MedicineMedical OncologyNo
9207R00000XInternal MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10251856MEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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