Individual provider Active NPI

Katie E Machanda, MD

  • Pediatrics Physician
  • Toledo, OH
National Provider Identifier
1063542025
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35-085743 Issued in OH
Practice address
7140 Port Sylvania Dr
Suite 420
Toledo, OH 43617-1176
Phone
(419) 843-8145
Fax
(419) 841-7735
NPI assigned
Mar 7, 2007
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35085743 OH
Pediatrics Physician 208000000X 35-085743 OH Primary

Addresses

Primary practice location

7140 Port Sylvania Dr
Suite 420
Toledo, OH 43617-1176

Mailing address

7140 Port Sylvania Dr
Suite 420
Toledo, OH 43617-1176
Phone (419) 843-8145

Other identifiers 9

IdentifierTypeStateIssuer
1018945270001MedicaidPA
2638917MedicaidOH
363791OtherOHWELLCARE
745938OtherOHBUCKEYE
7410792OtherOHAETNA
000000221389OtherOHUNISON
2638917OtherOHBCMH
000000391796OtherOHANTHEM
1018297610001MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmachanda7642@epicdirect.promedica.org

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
I20060227000675 OH Practitioner - Pediatric MedicinePractitioner - Internal Medicine 7113933219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Internal Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

2109 Hughes Dr
Suite 450
Toledo, OH 43606-5102
Phone (419) 291-2003

2901 N Reynolds Rd
Toledo, OH 43606
Phone (419) 578-7700

5308 Harroun Rd
Sylvania, OH 43560-2174

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35085743OHMDInternal Medicine Physician
35-085743OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians Internal Medicine CurrentSince Aug 18, 2009 Accepting new patients
Promedica Central Physicians CurrentSince Aug 18, 2009 Accepting new patients
The Toledo Hospital Pediatrics Past Accepting new patients

Locations

5308 Harroun Rd
Ste 155
Sylvania, OH 43560
Phone (419) 824-6100

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

7140 Port Sylvania Dr
Ste 420
Toledo, OH 43617
Phone (419) 843-8145

Interoperability endpoints

  • Direct secure messaging: kmachanda7642@direct.promedica.org
  • Direct secure messaging: kmachanda7642@epicdirect.promedica.org

Organizations & group practices 3

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

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": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1063542025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7140 PORT SYLVANIA DR",
            "address_2": "SUITE 420",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436171176",
            "telephone_number": "419-843-8145",
            "fax_number": "419-841-7735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7140 PORT SYLVANIA DR",
            "address_2": "SUITE 420",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436171176",
            "telephone_number": "419-843-8145",
            "fax_number": "419-841-7735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACHANDA",
        "first_name": "KATIE",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35085743",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35-085743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018945270001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2638917",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "363791",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEYE",
            "identifier": "745938",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7410792",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "000000221389",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCMH",
            "identifier": "2638917",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000391796",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018297610001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmachanda7642@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.