Individual provider Active NPI

Samuel Getachew, M.D.

  • Pediatrics Physician
  • Lorain, OH
National Provider Identifier
1770557001
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35059976 Issued in OH
Practice address
2152 Reid Ave
Lorain, OH 44052-4722
Phone
(440) 244-1677
Fax
(440) 244-1679
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X 35059976 OH
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 35059976G OH
Pediatrics Physician 208000000X 35059976 OH Primary

Addresses

Primary practice location

2152 Reid Ave
Lorain, OH 44052-4722

Mailing address

2152 Reid Ave
Lorain, OH 44052-4722
Phone (440) 244-1677

Other practice location 1

1050 Kingsmill Pkwy
Columbus, OH 43229-1143
Phone (614) 987-7977

Other identifiers 1

IdentifierTypeStateIssuer
0838259MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35059976GOHMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1770557001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2152 REID AVE",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440524722",
            "telephone_number": "440-244-1677",
            "fax_number": "440-244-1679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2152 REID AVE",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440524722",
            "telephone_number": "440-244-1677",
            "fax_number": "440-244-1679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 Kingsmill Pkwy",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432291143",
            "country_code": "US",
            "telephone_number": "614-987-7977",
            "fax_number": "614-505-6113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GETACHEW",
        "first_name": "SAMUEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OH",
            "license": "35059976",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "OH",
            "license": "35059976G",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35059976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0838259",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorain, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.