Individual provider Active NPI

Kshama M Daphtary, MD

  • Pediatric Critical Care Medicine Physician
  • Cleveland, OH
National Provider Identifier
1083649388
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
35.097764 Issued in OH
Practice address
9500 Euclid Ave # M14
Cleveland, OH 44195-0001
Phone
(216) 445-2748
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 35.097764 OH Primary

Addresses

Primary practice location

9500 Euclid Ave # M14
Cleveland, OH 44195-0001

Mailing address

9500 Euclid Ave # M14
Cleveland, OH 44195-0001

Other identifiers 6

IdentifierTypeStateIssuer
101469970MedicaidPA
922840MedicaidAZ
8384695MedicaidWA
100502560MedicaidNV
200257650MedicaidKS
XPY201557MedicaidCA

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
I20110830000411 OH Practitioner - Pediatric MedicinePractitioner - Other (Physician) 9234309295 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Aug 12, 2011 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients

Locations

9500 Euclid Ave
#M14
Cleveland, OH 44195
Phone (216) 212-3601

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

Interoperability endpoints

  • Direct secure messaging: kdaphtary145970@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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1083649388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE # M14",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE # M14",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-445-2748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAPHTARY",
        "first_name": "KSHAMA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "OH",
            "license": "35.097764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101469970",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "922840",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8384695",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100502560",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200257650",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XPY201557",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.