Individual provider Active NPI

Katrina Cisaruk Rakowsky, D.O.

  • Neuromusculoskeletal Medicine & OMM Physician
  • Warrensville Heights, OH
National Provider Identifier
1851498281
Registry record updated Oct 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
34007101 Issued in OH
Practice address
4100 Warrensville Center Road
Suite 102
Warrensville Heights, OH 44122-7099
Phone
(216) 491-7362
Fax
(216) 491-6587
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 34007101 OH Primary

Addresses

Primary practice location

4100 Warrensville Center Road
Suite 102
Warrensville Heights, OH 44122-7099

Mailing address

4100 Warrensville Center Road
Suite 102
Warrensville Heights, OH 44122-7099
Phone (216) 491-7362

Other identifiers 2

IdentifierTypeStateIssuer
000000147311OtherOHANTHEM BCBS
2195075MedicaidOH

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
I20071210000262 OH Practitioner - Osteopathic Manipulative MedicinePractitioner - Family Practice 2961591219 Practice locations: Beachwood, OH

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative MedicineAlso: Family Practice
Education
Michigan State University College of Osteopathic Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4100 Warrensville Ctr Rd
Suite 102
Beachwood, OH 44122-7024
Phone (216) 491-7362

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34007101OHMDNeuromusculoskeletal Medicine & OMM Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meridia Medical Group, 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.

Hospital & facility affiliations 3

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414627200000",
    "number": "1851498281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 WARRENSVILLE CENTER ROAD",
            "address_2": "SUITE 102",
            "city": "WARRENSVILLE HEIGHTS",
            "state": "OH",
            "postal_code": "441227099",
            "telephone_number": "216-491-7362",
            "fax_number": "216-491-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 WARRENSVILLE CENTER ROAD",
            "address_2": "SUITE 102",
            "city": "WARRENSVILLE HEIGHTS",
            "state": "OH",
            "postal_code": "441227099",
            "telephone_number": "216-491-7362",
            "fax_number": "216-491-6587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAKOWSKY",
        "first_name": "KATRINA",
        "middle_name": "CISARUK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2014-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "OH",
            "license": "34007101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000147311",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2195075",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrensville Heights, OH

Sources for this page

Verify at the official NPI Registry.