Individual provider Active NPI

Katherine Camille Disano, M.D.

  • Dermatology Physician
  • Cleveland, OH
National Provider Identifier
1053604207
Registry record updated Dec 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
BP10040625 Issued in TX
Practice address
2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone
(216) 778-5394
NPI assigned
May 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2015

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 BP10040625 TX Primary

Addresses

Primary practice location

2500 Metrohealth Dr
Cleveland, OH 44109-1900

Mailing address

2500 Metrohealth Dr
Department of Dermatology
Cleveland, OH 44109-1900
Phone (216) 778-3376

Other names 1

  • Katherine Camille Burt Former name

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
I20150629000770 OH Practitioner - Dermatology 9133361306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Texas Medical School at Houston, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Metrohealth SystemGroup PAC ID 8628982949, 1,150 clinicians

Practice addresses (Care Compare)

2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone (216) 778-7800

Hospital & facility affiliations

  • Metrohealth System Hospital, Cleveland, OH, CCN 360059

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions67
Skin biopsy57

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10040625TXMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System CurrentSince Jun 9, 2015 Accepting new patients
The Metrohealth System Current Accepting new patients
The Metrohealth System Dermatology CurrentSince Jun 9, 2015 Accepting new patients
The Metrohealth System Past Accepting new patients

Locations

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

4229 Pearl Rd
Cleveland, OH 44109
Phone (216) 459-6300

38 Main St
Ste 300
Westlake, OH 44145
Phone (216) 957-3200

Interoperability endpoints

  • Direct secure messaging: kdisano49972@direct.metrohealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1305849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449014400000",
    "number": "1053604207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DR",
            "address_2": "DEPARTMENT OF DERMATOLOGY",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091900",
            "telephone_number": "216-778-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091900",
            "telephone_number": "216-778-5394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISANO",
        "first_name": "KATHERINE",
        "middle_name": "CAMILLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-20",
        "last_updated": "2015-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "BP10040625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "BURT",
            "middle_name": "CAMILLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.