Individual provider Active NPI

Kathy Siesel, D.P.M.

  • Podiatrist
  • Cleveland, OH
National Provider Identifier
1124024328
Registry record updated Feb 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36-00-2592-S Issued in OH
Practice address
7000 Euclid Ave
Suite 101
Cleveland, OH 44103-4014
Phone
(216) 231-5612
Fax
(216) 721-5534
NPI assigned
Jun 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 36-00-2592-S OH Primary

Addresses

Primary practice location

7000 Euclid Ave
Suite 101
Cleveland, OH 44103-4014

Mailing address

7000 Euclid Ave
Suite 101
Cleveland, OH 44103-4014
Phone (216) 231-5612

Other identifiers 5

IdentifierTypeStateIssuer
1563848MedicaidOH
480031292OtherOHRR MEDICARE CFAC
0875101MedicaidOH
CH5179OtherOHRR MEDICARE GROUP CFAC
P00065177OtherOHRR MEDICARE

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051011000390 OH Practitioner - Podiatry 7416972518 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ksu Foot & Ankle Clinic Podiatrist CurrentSince Jul 1, 2012 Accepting new patients

Locations

7000 Euclid Ave
Ste 101
Cleveland, OH 44103
Phone (216) 231-5612

6000 Rockside Woods Blvd N
Independence, OH 44131
Phone (216) 231-5612

Organizations & group practices 1

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361836800000",
    "number": "1124024328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 EUCLID AVE",
            "address_2": "SUITE 101",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441034014",
            "telephone_number": "216-231-5612",
            "fax_number": "216-721-5534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 EUCLID AVE",
            "address_2": "SUITE 101",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441034014",
            "telephone_number": "216-231-5612",
            "fax_number": "216-721-5534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIESEL",
        "first_name": "KATHY",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2013-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36-00-2592-S",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1563848",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE CFAC",
            "identifier": "480031292",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0875101",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP CFAC",
            "identifier": "CH5179",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00065177",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.