Individual provider Active NPI

Khristiana Samake

  • Student in an Organized Health Care Education/Training Program
  • Cleveland, OH
National Provider Identifier
1649902867
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
10900 Euclid Ave
Cleveland, OH 44106-1712
Phone
(216) 368-0575
NPI assigned
Jun 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

10900 Euclid Ave
Cleveland, OH 44106-1712

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
I20250820002914 OH Practitioner - Physician Assistant 9436659943

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9110 Mentor Ave
Unit 9B
Mentor, OH 44060-6404

PO Box
Suite 10417
Holyoke, MA 01041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Suhas LLC Past Accepting new patients

Organizations & group practices 1

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": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1649902867",
    "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": "10900 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061712",
            "telephone_number": "216-368-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMAKE",
        "first_name": "KHRISTIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-27",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.