NPIMap

Individual provider Active NPI

Dmitri Souza, M.D., PH.D.

  • Pain Medicine (Anesthesiology) Physician
  • Cuyahoga Falls, OH
National Provider Identifier
1578718821
Registry record updated Jun 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
35.096297 Issued in OH
Practice address
1900 23Rd St
Cuyahoga Falls, OH 44223-1404
Phone
(330) 971-7246
Fax
(330) 971-7256
NPI assigned
Nov 27, 2008
Last updated
Jun 23, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 35.096297 OH
Pain Medicine (Anesthesiology) Physician 207LP2900X 35.096297 OH Primary
Internal Medicine Physician 207R00000X 35.096297 OH

Addresses

Primary practice location

1900 23Rd St
Cuyahoga Falls, OH 44223-1404

Mailing address

1900 23Rd St
Cuyahoga Falls, OH 44223-1404
Phone (330) 971-7246

Other identifiers 1

IdentifierTypeStateIssuer
0052082MedicaidOH

Other names 1

  • Dmitri Souzdalnitski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111005000406 OH Practitioner - Interventional Pain ManagementPractitioner - AnesthesiologyPractitioner - Internal Medicine 9436321932 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Anesthesiology, Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WRH Physicians, IncGroup PAC ID 0840342366, 149 clinicians

Practice addresses (Care Compare)

1900 23Rd St
Cuyahoga Falls, OH 44223-1404
Phone (330) 971-7246

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
WRH Physicians, Inc. CurrentSince Nov 19, 2012 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Aug 29, 2011 Accepting new patients
WRH Physicians, Inc. Anesthesiology CurrentSince Nov 19, 2012 Accepting new patients

Locations

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

1900 23rd St
Ste 1000
Cuyahoga Falls, OH 44223
Phone (330) 591-9635

1900 23rd St
Cuyahoga Fls, OH 44223
Phone (330) 929-2685

3033 State Rd
Ste 101
Cuyahoga Fls, OH 44223
Phone (330) 923-8372

12300 McCracken Rd
Garfield Hts, OH 44125
Phone (216) 581-0500

Interoperability endpoints

  • Direct secure messaging: dmitri.souzdalnitski@wrhs.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1227744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498176000000",
    "number": "1578718821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 23RD ST",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442231404",
            "telephone_number": "330-971-7246",
            "fax_number": "330-971-7256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 23RD ST",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442231404",
            "telephone_number": "330-971-7246",
            "fax_number": "330-971-7256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUZA",
        "first_name": "DMITRI",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-27",
        "last_updated": "2017-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35.096297",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "OH",
            "license": "35.096297",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.096297",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0052082",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DMITRI",
            "last_name": "SOUZDALNITSKI",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cuyahoga Falls, OH

Sources for this page

Verify at the official NPI Registry.