Individual provider Active NPI

David K Magnuson, MD

  • Pediatric Surgery Physician
  • Cleveland, OH
National Provider Identifier
1699795377
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
35-074721 Issued in OH
Practice address
11100 Euclid Ave
Cleveland, OH 44106-1716
Phone
(216) 844-7874
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X 35-074721 OH Primary

Addresses

Primary practice location

11100 Euclid Ave
Cleveland, OH 44106-1716

Mailing address

3605 Warrensville Center Rd
Shaker Heights, OH 44122-5203
Phone (440) 684-5979

Other identifiers 1

IdentifierTypeStateIssuer
2070271MedicaidOH

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
I20040407000517 OH Practitioner - General Surgery 4789677402 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-074721OHMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
The Cleveland Clinic Foundation CurrentSince Mar 14, 2013 Accepting new patients

Locations

2801 Mlk Dr
Cleveland, OH 44104
Phone (216) 448-6400

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

11100 Euclid Ave
Cleveland Heights, OH 44106

5001 Rockside Rd
Independence, OH 44131

6801 Mayfield Rd
Ste 200
Mayfield Heights, OH 44124
Phone (440) 312-4981

6780 Mayfield Rd
Mayfield Hts, OH 44124
Phone (440) 331-9520

19800 Detroit Rd
Rocky River, OH 44116
Phone (440) 333-1107

8701 Darrow Rd
Twinsburg, OH 44087
Phone (330) 888-4000

Interoperability endpoints

  • Direct secure messaging: dmagnusonmd51608@direct.ccf.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699795377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 WARRENSVILLE CENTER RD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441225203",
            "telephone_number": "440-684-5979",
            "fax_number": "440-684-5952"
        },
        {
            "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": "216-844-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGNUSON",
        "first_name": "DAVID",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "OH",
            "license": "35-074721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2070271",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.