Individual provider Active NPI

Kaye A. Myton-Craig, M.D.

  • Internal Medicine Physician
  • Beachwood, OH
National Provider Identifier
1750389441
Registry record updated Jun 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.067681 Issued in OH
Practice address
3619 Park East Dr
Suite 205 S
Beachwood, OH 44122-4330
Phone
(216) 591-0942
Fax
(216) 591-0943
NPI assigned
Jul 7, 2005
Reactivated
Mar 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.067681 OH Primary

Addresses

Primary practice location

3619 Park East Dr
Suite 205 S
Beachwood, OH 44122-4330

Mailing address

3619 Park East Dr
Suite 205 S
Beachwood, OH 44122-4330
Phone (216) 591-0942

Other identifiers 1

IdentifierTypeStateIssuer
0102249MedicaidOH

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
I20100218000905 OH Practitioner - Internal Medicine 6901813229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

24100 Chargin Blvd
Suite 150
Beachwood, OH 44122
Phone (216) 591-0942

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.067681OHMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: kaye.myton-craig@ehi.direct-ci.com

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.

Hospital & facility affiliations 5

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339632000000",
    "number": "1750389441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3619 PARK EAST DR",
            "address_2": "SUITE 205 S",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224330",
            "telephone_number": "216-591-0942",
            "fax_number": "216-591-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3619 PARK EAST DR",
            "address_2": "SUITE 205 S",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224330",
            "telephone_number": "216-591-0942",
            "fax_number": "216-591-0943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYTON-CRAIG",
        "first_name": "KAYE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2012-06-14",
        "deactivation_date": "2006-03-15",
        "reactivation_date": "2006-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.067681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0102249",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.