Individual provider Active NPI

Shelly David Senders, MD

  • Pediatrics Physician
  • South Euclid, OH
National Provider Identifier
1629030242
Registry record updated Mar 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35053726 Issued in OH
Practice address
2054 South Green Road
South Euclid, OH 44121
Phone
(216) 291-9210
Fax
(216) 291-9422
NPI assigned
Apr 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35053726 OH Primary

Addresses

Primary practice location

2054 South Green Road
South Euclid, OH 44121

Mailing address

2054 South Green Road
South Euclid, OH 44121
Phone (216) 291-9210

Other identifiers 2

IdentifierTypeStateIssuer
0630437MedicaidOH
6304371MedicaidOH

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
I20211013003502 OH Practitioner - Pediatric Medicine 9830597301 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35053726OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Shelly David Senders, MD, Inc Pediatrics CurrentSince Jul 15, 2021 Accepting new patients
University Hospitals Cleveland Medical Center Past Accepting new patients
Cleveland Clinic Health System - East Region Past Accepting new patients

Locations

2054 S Green Rd
South Euclid, OH 44121
Phone (216) 291-9210

Interoperability endpoints

  • Direct secure messaging: ssenders35937@ehrdirect.uhhospitals.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333065600000",
    "number": "1629030242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2054 SOUTH GREEN ROAD",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "44121",
            "telephone_number": "216-291-9210",
            "fax_number": "216-291-9422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2054 SOUTH GREEN ROAD",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "44121",
            "telephone_number": "216-291-9210",
            "fax_number": "216-291-9422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SENDERS",
        "first_name": "SHELLY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2012-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35053726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0630437",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6304371",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Euclid, OH

Sources for this page

Verify at the official NPI Registry.