Individual provider Active NPI

Susan D Raphaely, MD

  • Anesthesiology Physician
  • Cleveland, OH
National Provider Identifier
1669587747
Registry record updated Aug 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
35-066167 Issued in OH
Practice address
11100 Euclid Ave
Cleveland, OH 44106-1716
Phone
(216) 844-7330
Fax
(216) 844-3781
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2010

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 35-066167 OH Primary
Addiction Medicine (Anesthesiology) Physician 207LA0401X 35-066167 OH
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 35-066167 OH
Hospice and Palliative Medicine (Anesthesiology) Physician 207LH0002X 35-066167 OH
Pain Medicine (Anesthesiology) Physician 207LP2900X 35-066167 OH
Pediatric Anesthesiology Physician 207LP3000X 35-066167 OH

Addresses

Primary practice location

11100 Euclid Ave
Cleveland, OH 44106-1716

Mailing address

24701 Euclid Ave
3Rd Floor
Euclid, OH 44117-1714
Phone (216) 383-6616

Other identifiers 9

IdentifierTypeStateIssuer
0583328OtherOHBCMH
000000516056OtherOHANTHEM
5229680OtherOHAETNA
000000221133OtherOHUNISON
2042284MedicaidOH
744154OtherOHBUCKEYE MEDICAID
P00077454OtherOHRAILROAD MEDICARE
363936OtherOHWELLCARE MEDICAID
P00385140OtherOHMEDICARE RAILROAD

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
I20070425000072 OH Practitioner - Anesthesiology 4880799519 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-066167OHMDPediatric Anesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Ohio Anesthesia Consultants LLC Anesthesiology CurrentSince Sep 1, 2024 Accepting new patients
Radius Anesthesia of Ohio, LLC Anesthesiology CurrentSince Jan 1, 2026 Accepting new patients
Anesthesia & Intensive Care Consultants,Inc. Anesthesiology CurrentSince Sep 1, 2024 Accepting new patients
Columbus Anesthesia Services LLC Anesthesiology CurrentSince Jan 1, 2026 Accepting new patients
University Anesthesiologists, Inc. Anesthesiology Past Accepting new patients

Locations

111 Town Square Pl
Ste 420
Jersey City, NJ 07310
Phone (201) 258-4700

7500 State Rd
Cincinnati, OH 45255
Phone (513) 624-4034

100 E Campus View Blvd
Ste 250
Columbus, OH 43235
Phone (267) 817-8902

175 S 3rd St
Ste 200
Columbus, OH 43215
Phone (267) 817-8902

Organizations & group practices 5

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282176000000",
    "number": "1669587747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24701 EUCLID AVE",
            "address_2": "3RD FLOOR",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441171714",
            "telephone_number": "216-383-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061716",
            "telephone_number": "216-844-7330",
            "fax_number": "216-844-3781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAPHAELY",
        "first_name": "SUSAN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2010-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35-066167",
            "primary": true
        },
        {
            "code": "207LA0401X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Addiction Medicine",
            "state": "OH",
            "license": "35-066167",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "OH",
            "license": "35-066167",
            "primary": false
        },
        {
            "code": "207LH0002X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Hospice and Palliative Medicine",
            "state": "OH",
            "license": "35-066167",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "OH",
            "license": "35-066167",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "OH",
            "license": "35-066167",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCMH",
            "identifier": "0583328",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000516056",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5229680",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "000000221133",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2042284",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEYE MEDICAID",
            "identifier": "744154",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00077454",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE MEDICAID",
            "identifier": "363936",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00385140",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.