Individual provider Active NPI

Sophia Orraca-Tetteh, MD

  • Pediatrics Physician
  • Cleveland, OH
National Provider Identifier
1063423069
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35059847 Issued in OH
Practice address
2816 E 116TH St
Metrohealth Buckeye Health Center
Cleveland, OH 44120-2111
Phone
(216) 957-4000
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35059847 OH Primary

Addresses

Primary practice location

2816 E 116TH St
Metrohealth Buckeye Health Center
Cleveland, OH 44120-2111

Mailing address

2816 E 116TH St
Metrohealth Buckeye Health Center
Cleveland, OH 44120-2111
Phone (216) 957-4000

Other identifiers 1

IdentifierTypeStateIssuer
0947533MedicaidOH

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
I20050908000623 OH Practitioner - Pediatric Medicine 1759313927 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35059847OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System Pediatrics CurrentSince Sep 18, 2010 Accepting new patients
The Metrohealth System CurrentSince Sep 18, 2010 Accepting new patients

Locations

2816 E 116th St
Cleveland, OH 44120
Phone (216) 696-3876

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

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

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063423069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2816 E 116TH ST",
            "address_2": "METROHEALTH BUCKEYE HEALTH CENTER",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441202111",
            "telephone_number": "216-957-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2816 E 116TH ST",
            "address_2": "METROHEALTH BUCKEYE HEALTH CENTER",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441202111",
            "telephone_number": "216-957-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORRACA-TETTEH",
        "first_name": "SOPHIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35059847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0947533",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.