Active NPI
Akari Tichavakunda, M.D.
- Pediatrics Physician
- Cleveland, OH
National Provider Identifier
1366431850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 35-064983
- Practice address
- 14100 Cedar Rd
Suite 270
Cleveland, OH 44121-3212 - Phone
- (216) 382-0555
- Fax
- (216) 382-0726
- NPI assigned
- Oct 18, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 35-064983 | OH | Primary |
Addresses
Primary practice location
14100 Cedar Rd
Suite 270
Cleveland, OH 44121-3212
Mailing address
14100 Cedar Rd
Suite 270
Cleveland, OH 44121-3212
Phone (216) 382-0555
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000133808 | Other | OH | ANTHEM |
| 0929740 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35-064983 | OH | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Life Recovery Clinic 2 | Current | Accepting new patients | |
| Lima Memorial Joint Operating Company | 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 and National Provider Directory roles.
-
- General Practice Physician
- Beachwood, OH
- NPI 1528711801
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455840000000",
"number": "1366431850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14100 CEDAR RD",
"address_2": "SUITE 270",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441213212",
"telephone_number": "216-382-0555",
"fax_number": "216-382-0726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14100 CEDAR RD",
"address_2": "SUITE 270",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441213212",
"telephone_number": "216-382-0555",
"fax_number": "216-382-0726"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TICHAVAKUNDA",
"first_name": "AKARI",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-18",
"last_updated": "2016-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OH",
"license": "35-064983",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000133808",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0929740",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.