Individual provider Active NPI

Casey Richard Charlton

  • Internal Medicine Physician
  • Cleveland, OH
National Provider Identifier
1609554658
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
50.009096RX Issued in OH
Practice address
18101 Lorain Ave
Cleveland, OH 44111-5612
Phone
(216) 368-0575
NPI assigned
Jul 10, 2023
Last updated
Dec 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 50.009096RX OH Primary

Addresses

Primary practice location

18101 Lorain Ave
Cleveland, OH 44111-5612

Mailing address

10900 Euclid Ave
Cleveland, OH 44106-1712
Phone (216) 368-0575

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250421002673 OH Practitioner - Physician Assistant 0143745265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview HospitalGroup PAC ID 4688571730, 74 clinicians

Practice addresses (Care Compare)

10654 Lorain Ave
Cleveland, OH 44111-5411
Phone (216) 941-1044

18101 Lorain Ave
Cleveland, OH 44111-5612
Phone (216) 476-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50.009096RXOHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Hospital CurrentSince Feb 14, 2025 Accepting new patients

Locations

10654 Lorain Ave
Cleveland, OH 44111
Phone (216) 941-1044

18101 Lorain Ave
Cleveland, OH 44111
Phone (216) 476-7029

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Organizations & group practices 2

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 2

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": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1609554658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061712",
            "telephone_number": "216-368-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 LORAIN AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441115612",
            "telephone_number": "216-368-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLTON",
        "first_name": "CASEY",
        "middle_name": "RICHARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-10",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "50.009096RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.