Stephanus Eric Haryadi, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35.135310 Issued in OH

Practice address

315 E Main St
Orwell, OH 44076-9590

Phone

(440) 437-6222

Fax

(440) 437-1022

NPI assigned

May 19, 2015

Last updated

Feb 3, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Internal Medicine

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2015

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)

Hospital & facility affiliations

• Metrohealth System Hospital, Cleveland, OH, CCN 360059

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sharyadi255495@direct.metrohealth.org
• Direct secure messaging: sharyadi37337@ehrdirect.uhhospitals.org

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.

• The Metrohealth System

  dba Metrohealth Professional Group

  • Multi-Specialty Clinic/Center
  • Cleveland, OH
  • NPI 1053353896

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• The Metrohealth System

  dba Metrohealth Medical Center

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1700828852
  NPD
• The Metrohealth System

  dba MetroHealth Brooklyn Memphis Pharmacy

  • Pharmacy
  • Cleveland, OH
  • NPI 1992529911
  NPD

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

• The Metrohealth System

  dba Metrohealth Life Flight

  • Air Ambulance
  • Cleveland, OH
  • NPI 1609043645

  Hospital

  Care Compare affiliation
• The Metrohealth System

  dba Metrohealth Medical Center

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1700828852
  Care Compare affiliation

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

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1174902498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8055 MAYFIELD RD STE 105",
            "city": "CHESTERLAND",
            "state": "OH",
            "postal_code": "440262447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E MAIN ST",
            "city": "ORWELL",
            "state": "OH",
            "postal_code": "440769590",
            "telephone_number": "440-437-6222",
            "fax_number": "440-437-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARYADI",
        "first_name": "STEPHANUS",
        "middle_name": "ERIC",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-19",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.135310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephanusharyadi@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "315 E Main St",
            "city": "Orwell",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440769590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Denise A Fisher, ATC, PTA, LMT
• Nicole Gama, R.N.
• Grand Valley Local Schools
• Tracy R Greb, PT
• Tamara Lea Gutierrez, MD
• Linda Jacques
• Keystone Rehabilitation Systems Inc (NovaCare Rehabilitation)
• Kenneth L Lawrence, DDS
• Joan D Limpert, STNA
• Brenda Loomis

• Internal Medicine Physician in Orwell, OH
• Providers in Orwell, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.