Individual provider Active NPI

Shelly Debbie Pesick-Caine, M.D.

  • Pediatrics Physician
  • Mayfield Village, OH
National Provider Identifier
1427059567
Registry record updated Oct 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35056188 Issued in OH
Practice address
6559 Wilson Mills Rd
BLDG D Suite 101
Mayfield Village, OH 44143-6402
Phone
(440) 473-0010
Fax
(440) 460-2812
NPI assigned
Aug 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35056188 OH Primary

Addresses

Primary practice location

6559 Wilson Mills Rd
BLDG D Suite 101
Mayfield Village, OH 44143-6402

Mailing address

6775 Ridgecliff Dr
Solon, OH 44139-3884
Phone (440) 248-2481

Other identifiers 5

IdentifierTypeStateIssuer
000000026098OtherOHUNICARE LIFE AND HEALTH
380761OtherOHWELLCARE
000000026098OtherOHANTHEM BCBS
0744921MedicaidOH
R56188OtherOHSUMMARE HEALTH PLAN

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161216002172 OH Practitioner - Pediatric Medicine 7618257262 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35056188OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
The Cleveland Clinic Foundation CurrentSince Nov 9, 2016 Accepting new patients
Hillcrest Pediatrics Inc. Pediatrics Past Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

6801 Mayfield Rd
Mayfield Hts, OH 44124
Phone (440) 312-4515

Interoperability endpoints

  • Direct secure messaging: spesickcaine32641@direct.ccf.org

Organizations & group practices 3

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319932800000",
    "number": "1427059567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6775 RIDGECLIFF DR",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441393884",
            "telephone_number": "440-248-2481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6559 WILSON MILLS RD",
            "address_2": "BLDG D SUITE 101",
            "city": "MAYFIELD VILLAGE",
            "state": "OH",
            "postal_code": "441436402",
            "telephone_number": "440-473-0010",
            "fax_number": "440-460-2812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESICK-CAINE",
        "first_name": "SHELLY",
        "middle_name": "DEBBIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-10",
        "last_updated": "2011-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35056188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNICARE LIFE AND HEALTH",
            "identifier": "000000026098",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "380761",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000026098",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0744921",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUMMARE HEALTH PLAN",
            "identifier": "R56188",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield Village, OH

Sources for this page

Verify at the official NPI Registry.