Renuka Diwan, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

35.050695 Issued in OH

Practice address

29101 Health Campus Dr
Suite 300
Westlake, OH 44145-5270

Phone

(440) 871-9832

Fax

(440) 871-0816

NPI assigned

Oct 23, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: laserandskinsurgerycenter@ppdxdirect.com

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477636850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30855 RIVIERA LN",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441451785",
            "telephone_number": "440-871-9832",
            "fax_number": "440-871-0816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29101 HEALTH CAMPUS DR",
            "address_2": "SUITE 300",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455270",
            "telephone_number": "440-871-9832",
            "fax_number": "440-871-0816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIWAN",
        "first_name": "RENUKA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "OH",
            "license": "35.050695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aravind Lingo Dipali, M.D
• Discount Drug Mart Inc
• Richard Guenter Dittmer, DO
• Steven Richard Ditto, M.D.
• David Divins, RBT
• Kenneth Dix, RBT
• DK Michelle
• Dnary Association LLC
• Kassia Doaty, RBT
• Michael J Dobrovich, DO

• MOHS-Micrographic Surgery Physician in Westlake, OH
• Providers in Westlake, OH by specialty
• MOHS-Micrographic Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.