Individual provider Active NPI

Craig Djukic

  • Clinical Social Worker
  • Willoughby Hills, OH
National Provider Identifier
1851798599
Registry record updated Jan 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.160031 Issued in OH
Practice address
2550 Som Center Rd
Willoughby Hills, OH 44094-9655
Phone
(440) 943-2500
NPI assigned
Nov 24, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.160031 OH Primary

Addresses

Primary practice location

2550 Som Center Rd
Willoughby Hills, OH 44094-9655

Mailing address

3737 Lander Rd
Pepper Pike, OH 44124-5712

Other identifiers 1

IdentifierTypeStateIssuer
2871101MedicaidOH

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180308001987 OH Practitioner - Clinical Social Worker 9931460938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

2570 Som Ctr Rd
Willoughby Hills, OH 44094-9607
Phone (440) 943-2500

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.160031OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Feb 28, 2018 Accepting new patients

Locations

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

2550 Som Center Rd
Willoughby Hills, OH 44094
Phone (440) 516-8620

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 1

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": "1416787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515628800000",
    "number": "1851798599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 LANDER RD",
            "city": "PEPPER PIKE",
            "state": "OH",
            "postal_code": "441245712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 SOM CENTER RD",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440949655",
            "telephone_number": "440-943-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJUKIC",
        "first_name": "CRAIG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-24",
        "last_updated": "2018-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.160031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2871101",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby Hills, OH

Sources for this page

Verify at the official NPI Registry.