Amy Hehr Kassouf, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

35065826 Issued in OH

Practice address

1611 S Green Rd
Suite 146
South Euclid, OH 44121-4128

Phone

(216) 382-3806

Fax

(216) 382-6735

NPI assigned

Dec 10, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

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

Dermatology

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cleveland Clinic Hospital, Cleveland, OH, CCN 360180

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Medicare reassignment Care Compare group NPD

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

• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Care Compare affiliation

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200873600000",
    "number": "1295918597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 S GREEN RD",
            "address_2": "SUITE 146",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441214128",
            "telephone_number": "216-382-3806",
            "fax_number": "216-382-6735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 S GREEN RD",
            "address_2": "SUITE 146",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441214128",
            "telephone_number": "216-382-3806",
            "fax_number": "216-382-6735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSOUF",
        "first_name": "AMY",
        "middle_name": "HEHR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-10",
        "last_updated": "2008-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35065826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2070735",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1154487932",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE LEGACY NUM",
            "identifier": "9186053",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE LEGACY NUM",
            "identifier": "9186057",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP LEGACY NUM",
            "identifier": "9186052",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP LEGACY NUM",
            "identifier": "9186055",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Philip Donald Junglas, M.D.
• Just Right Nursing Solutions LLC
• Theresa Kahler
• Heeba Kaleem, PA-C
• Tiara Kaseda, LPN
• Georgianna Perara Kates, M.D.
• Julia Kellom
• Kelly M Kelmes, CNP
• Anthony Tyrell Kennedy
• Molly Marie Kennedy, CPNP

• Dermatology Physician in South Euclid, OH
• Providers in South Euclid, OH by specialty
• Dermatology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2008; 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.