Individual provider Active NPI

Esti G Gumpertz, M.D.

Procedural Dermatology Physician
Mayfield HTS, OH

National Provider Identifier

1285602433

Registry record updated Oct 3, 2008

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
Organizations & group practices2
NPI Registry JSON
Other providers in Mayfield HTS, OH
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License: 35052867 Issued in OH
Practice address: 6801 Mayfield Rd
Suite 244
Mayfield HTS, OH 44124-2270
Phone: (440) 646-1600
Fax: (440) 646-1505
NPI assigned: Mar 12, 2006
Last updated: Oct 3, 2008By the provider in NPPES
Sex: Female
Sole proprietor: Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)	Code	License	State	Primary
Procedural Dermatology Physician	207NS0135X	35052867	OH	Primary

Addresses

Primary practice location

6801 Mayfield Rd
Suite 244
Mayfield HTS, OH 44124-2270

Mailing address

6801 Mayfield Rd
Suite 244
Mayfield HTS, OH 44124-2270
Phone (440) 646-1600

Other identifiers 41

Identifier	Type	State	Issuer
3415377930001	Other		CHRISTIAN BROTHERS
3415377930001	Other		NIPPON LIFE INSURANCE
3415377930001	Other		RETIREE MEDICAL INSURANCE
3415377930001	Other		TPA
3415377930001	Other		UNICARE
3415377930001	Other		UNITED AMERICAN INSURANCE
351358	Other	OH	WELLCARE
0631034	Medicaid	OH
341537793	Other		NALC
341537793	Other		HUMANA
3415377930001	Other		FIRST HEALTH
3415377930001	Other		PRINCIPAL LIFE INSURANCE
3415377930001	Other		STAR ADMINISTRATION SERVICES
72503454006	Other		MEDICAL MUTUAL OF OHIO
0631034	Other	OH	PEOPLE'S HEALTH PLAN
341537793	Other		MAIL HANDLERS
34153779300	Other		MEDICAL ADMINISTRATORS
341537793026	Other	OH	CARESOURCE
R52867	Other		SUMACARE
000000133524	Other		BLUE CROSS / BLUE SHIELD
34153779300	Other	OH	BUREAU OF WORKERS COMPENSATION
3415377930001	Other		CIGNA
3415377930001	Other		COMMUNITY INSURANCE
3415377930001	Other		EMERALD HEALTH NETWORK
3415377930001	Other		EXPACARE
3415377930001	Other		OHIO CONFERENCE OF PLASTERERS
3415377930001	Other		OHIO HEALTH CHOICE
R52867	Other		APEX
07000311	Other	OH	RAILROAD MEDICARE
341537793	Other		PROFESSIONAL CLAIMS MANAGEMENT
736416	Other		BUCKEYE
341537793	Other		AETNA
102510	Other		KAISER PERMANENTE
341537793	Other		SECURE HORIZONS
341537793	Other		TRICARE
3415377930001	Other		GOLDEN RULE
3415377930001	Other		HEALTHLINK
34153779300	Other	OH	CAREWORKS
3415377930001	Other		FLORIDA HEALTH CARE PLANS
3415377930001	Other		GREAT WEST
3415377930001	Other		UNITED HEALTHCARE

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Enrolled
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
35052867	OH	MD	Procedural Dermatology Physician

Practice roles

Organization	Specialty	Status	New patients
SCH Professional Corporation		Past	Accepting new patients
Gary R Kutsikovich MD and Associates Inc		Past	Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Gary R Kutsikovich MD and Associates Inc
- Neurology Physician
- Mentor, OH
- NPI 1841250420
NPD (past)
SCH Professional Corporation
- Family Medicine Physician
- Salem, OH
- NPI 1619959822
NPD (past)

NPI Registry JSON

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

{
    "created_epoch": "1142121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222992000000",
    "number": "1285602433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 MAYFIELD RD",
            "address_2": "SUITE 244",
            "city": "MAYFIELD HTS",
            "state": "OH",
            "postal_code": "441242270",
            "telephone_number": "440-646-1600",
            "fax_number": "440-646-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 MAYFIELD RD",
            "address_2": "SUITE 244",
            "city": "MAYFIELD HTS",
            "state": "OH",
            "postal_code": "441242270",
            "telephone_number": "440-646-1600",
            "fax_number": "440-646-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMPERTZ",
        "first_name": "ESTI",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-12",
        "last_updated": "2008-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "OH",
            "license": "35052867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHRISTIAN BROTHERS",
            "identifier": "3415377930001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NIPPON LIFE INSURANCE",
            "identifier": "3415377930001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RETIREE MEDICAL INSURANCE",
            "identifier": "3415377930001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TPA",
            "identifier": "3415377930001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNICARE",
            "identifier": "3415377930001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED AMERICAN INSURANCE",
            "identifier": "3415377930001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "351358",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0631034",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NALC",
            "identifier": "341537793",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "341537793",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "3415377930001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRINCIPAL LIFE INSURANCE",
            "identifier": "3415377930001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STAR ADMINISTRATION SERVICES",
            "identifier": "3415377930001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL OF OHIO",
            "identifier": "72503454006",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEOPLE'S HEALTH PLAN",
            "identifier": "0631034",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAIL HANDLERS",
            "identifier": "341537793",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ADMINISTRATORS",
            "identifier": "34153779300",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "341537793026",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUMACARE",
            "identifier": "R52867",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS / BLUE SHIELD",
            "identifier": "000000133524",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUREAU OF WORKERS COMPENSATION",
            "identifier": "34153779300",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3415377930001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY INSURANCE",
            "identifier": "3415377930001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMERALD HEALTH NETWORK",
            "identifier": "3415377930001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXPACARE",
            "identifier": "3415377930001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO CONFERENCE OF PLASTERERS",
            "identifier": "3415377930001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO HEALTH CHOICE",
            "identifier": "3415377930001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APEX",
            "identifier": "R52867",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "07000311",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL CLAIMS MANAGEMENT",
            "identifier": "341537793",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEYE",
            "identifier": "736416",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "341537793",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER PERMANENTE",
            "identifier": "102510",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECURE HORIZONS",
            "identifier": "341537793",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "341537793",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GOLDEN RULE",
            "identifier": "3415377930001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "3415377930001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREWORKS",
            "identifier": "34153779300",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA HEALTH CARE PLANS",
            "identifier": "3415377930001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT WEST",
            "identifier": "3415377930001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "3415377930001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield HTS, OH

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.