Individual provider Active NPI

Pamela L. Redden, M.D.

  • Internal Medicine Physician
  • Cleveland, OH
National Provider Identifier
1467534164
Registry record updated Nov 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35047018 Issued in OH
Practice address
12100 Superior Ave
Cleveland, OH 44106-1444
Phone
(216) 851-2600
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35047018 OH Primary

Addresses

Primary practice location

12100 Superior Ave
Cleveland, OH 44106-1444

Mailing address

12100 Superior Ave
Cleveland, OH 44106-1444
Phone (216) 851-2600

Other identifiers 1

IdentifierTypeStateIssuer
0496958MedicaidOH

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
I20100914000326 OH Practitioner - Internal Medicine 3375668411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4800 Payne Ave
Cleveland, OH 44103-2443

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35047018OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Ohio Neighborhood Health Services, Inc. CurrentSince Jan 3, 2002 Accepting new patients
Northeast Ohio Neighborhood Health Services, Inc. Current Accepting new patients
Northeast Ohio Neighborhood Health Services, Inc. CurrentSince Jan 3, 2002 Accepting new patients
Northeast Ohio Neighborhood Health Services, Inc. Current Accepting new patients

Locations

8300 Hough Ave
Cleveland, OH 44103
Phone (216) 231-7700

12100 Superior Ave
Cleveland, OH 44106
Phone (216) 851-2600

4800 Payne Ave
Cleveland, OH 44103
Phone (216) 231-7700

Interoperability endpoints

  • Direct secure messaging: pamela.reddenmd.p1@direct.neon.nextgenshare.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447891200000",
    "number": "1467534164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12100 SUPERIOR AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061444",
            "telephone_number": "216-851-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 SUPERIOR AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061444",
            "telephone_number": "216-851-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDEN",
        "first_name": "PAMELA",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2015-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35047018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0496958",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.