Individual provider Active NPI

Angela O Kyei, M.D.

  • Dermatology Physician
  • Shaker Heights, OH
National Provider Identifier
1053593566
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
35.097340 Issued in OH
Practice address
3461 Warrensville Center Rd Ste 100
Shaker Heights, OH 44122-5227
Phone
(216) 417-3250
Fax
(216) 417-3251
NPI assigned
Nov 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 35.097340 OH Primary

Addresses

Primary practice location

3461 Warrensville Center Rd Ste 100
Shaker Heights, OH 44122-5227

Mailing address

2323 Lee Road
Cosmopolitan Dermatology
Cleveland Heights, OH 44118
Phone (216) 417-3250

Other identifiers 1

IdentifierTypeStateIssuer
0051799MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110729000281 OH Practitioner - Dermatology 1759559180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3461 Warrensville Ctr Rd
Suite 100
Shaker Heights, OH 44122-5227
Phone (216) 417-3250

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions89
Skin biopsy21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
Cosmopolitan Dermatology, Inc. Dermatology CurrentSince Jan 26, 2015 Accepting new patients

Locations

2351 E 22nd St
Cleveland, OH 44115
Phone (216) 363-2536

2323 Lee Rd
Cleveland Hts, OH 44118
Phone (216) 235-0408

3461 Warrensville Center Rd
Ste 100
Shaker Heights, OH 44122
Phone (216) 417-3250

Interoperability endpoints

  • Direct secure messaging: akyei67927@direct.ccf.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1053593566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 LEE ROAD",
            "address_2": "COSMOPOLITAN DERMATOLOGY",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "44118",
            "telephone_number": "216-417-3250",
            "fax_number": "216-417-3251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3461 WARRENSVILLE CENTER RD STE 100",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441225227",
            "telephone_number": "216-417-3250",
            "fax_number": "216-417-3251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYEI",
        "first_name": "ANGELA",
        "middle_name": "O",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-27",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35.097340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0051799",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shaker Heights, OH

Sources for this page

Verify at the official NPI Registry.