| Elite Medical Practice, LLC | |
|
21851 Center Ridge Rd Ste 109 Rocky River OH 44116-3901 | |
| (440) 331-5488 | |
| (440) 331-3790 |
| Full Name | Elite Medical Practice, LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 21851 Center Ridge Rd Ste 109, Rocky River, Ohio |
| Authorized Official Name and Position | Emile Sabbagh (MD/OWNER) |
| Authorized Official Contact | 4403315488 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Medical Practice, LLC Po Box 771508 Lakewood OH 44107-0060 Ph: (440) 331-5488 | Elite Medical Practice, LLC 21851 Center Ridge Rd Ste 109 Rocky River OH 44116-3901 Ph: (440) 331-5488 |
| NPI Number | 1730674037 |
|---|---|
| Provider Enumeration Date | 06/28/2018 |
| Last Update Date | 06/28/2018 |
| Medicare PECOS PAC ID | 9931458999 |
|---|---|
| Medicare Enrollment ID | O20180823003106 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730674037 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 35.082908 (Ohio) | Primary |
| Provider Name | Emile I Sabbagh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831165521 PECOS PAC ID: 6608846944 Enrollment ID: I20040726001413 |
| Provider Name | Abigail C Covell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1043632599 PECOS PAC ID: 8820229271 Enrollment ID: I20140327001040 |
| Provider Name | Laura C Pauley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639553191 PECOS PAC ID: 9436465978 Enrollment ID: I20150831000286 |
| Provider Name | Laura Gienke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295186757 PECOS PAC ID: 9638467350 Enrollment ID: I20161013000444 |
| Provider Name | Lori Janelle Donahue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518493410 PECOS PAC ID: 8426324195 Enrollment ID: I20171024003119 |
| Provider Name | Olumide B Ogunwumi |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245795236 PECOS PAC ID: 9638411515 Enrollment ID: I20190424001365 |
| Provider Name | Manjola Lamcaj |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598366197 PECOS PAC ID: 3375954993 Enrollment ID: I20201202002254 |
| Provider Name | Michal Sittek |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1295348324 PECOS PAC ID: 0143638007 Enrollment ID: I20210414002645 |
| Provider Name | Dylan Kenneth Kadow |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1841868890 PECOS PAC ID: 9032511332 Enrollment ID: I20210708003379 |
| Provider Name | Sydney a Bowen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881321396 PECOS PAC ID: 2466837380 Enrollment ID: I20220913003423 |
| Provider Name | Amelia Margaret Kaeberlein |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1497524490 PECOS PAC ID: 5496273476 Enrollment ID: I20250513003537 |
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Lakeshore Heart, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 21851 Center Ridge Rd, Suite 200, Rocky River, OH 44116 Phone: 440-333-0060 Fax: 440-333-0065 |
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Jensam LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 21851 Center Ridge Rd Ste 107, Rocky River, OH 44116 Phone: 216-221-7642 |