Individual provider Active NPI

Kristen A Echanique

  • Facial Plastic Surgery Physician
  • Cleveland, OH
National Provider Identifier
1902302615
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
35.148542 Issued in OH
Practice address
9500 Euclid Ave # A71
Cleveland, OH 44195-7419
Phone
(216) 444-2792
NPI assigned
Apr 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery Physician 207YS0123X 35.148542 OH Primary

Addresses

Primary practice location

9500 Euclid Ave # A71
Cleveland, OH 44195-7419

Mailing address

9500 Euclid Ave # A71
Cleveland, OH 44195-0001
Phone (216) 444-2792

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20241022002044 NJ Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 2860814563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

140 Bergen St
Newark, NJ 07103-2425
Phone (973) 972-9000

30 Bergen St
Newark, NJ 07107-3000
Phone (973) 972-0037

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.148542OHMDFacial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Associates of New Jersey Inc CurrentSince Sep 1, 2024 Accepting new patients
University Physician Associates of New Jersey Inc CurrentSince Sep 1, 2024 Accepting new patients
University Physician Associates of New Jersey Inc Past Accepting new patients

Locations

200 S Orange Ave
Ste 150
Livingston, NJ 07039
Phone (973) 322-7000

30 Bergen St
Rm 1205
Newark, NJ 07107
Phone (973) 972-0037

30 Bergen St
#12
Newark, NJ 07107
Phone (973) 972-0037

Organizations & group practices 3

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 2

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": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1902302615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE # A71",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-444-2792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE # A71",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441957419",
            "telephone_number": "216-444-2792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECHANIQUE",
        "first_name": "KRISTEN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-02",
        "last_updated": "2023-10-06",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "OH",
            "license": "35.148542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.