Active NPI
Amanda Kanaan
- Specialist
- Cleveland, OH
National Provider Identifier
1558060392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- ESTI153356
- Practice address
- 9500 Euclid Ave
Cleveland, OH 44195-0001 - Phone
- (216) 444-2200
- NPI assigned
- Mar 1, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Specialist | 174400000X | ESTI153356 | OH | Primary |
Addresses
Primary practice location
9500 Euclid Ave
Cleveland, OH 44195-0001
Mailing address
11576 Reserve Way
Columbia Station, OH 44028-9260
Phone (440) 241-1431
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ESTI153356 | OH | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677628800000",
"number": "1558060392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11576 RESERVE WAY",
"city": "COLUMBIA STATION",
"state": "OH",
"postal_code": "440289260",
"telephone_number": "440-241-1431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9500 EUCLID AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441950001",
"telephone_number": "216-444-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANAAN",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-01",
"last_updated": "2023-03-01",
"certification_date": "2023-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OH",
"license": "ESTI153356",
"primary": true
}
],
"identifiers": [],
"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 Mar 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.