Individual provider Active NPI

Debra Anne Dejoseph, M.D.

  • Internal Medicine Physician
  • South Euclid, OH
National Provider Identifier
1942216676
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35063951 Issued in OH
Practice address
1611 S Green Rd
Suite 065
South Euclid, OH 44121-4128
Phone
(216) 291-9171
Fax
(216) 291-1827
NPI assigned
Aug 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 35063951 OH Primary

Addresses

Primary practice location

1611 S Green Rd
Suite 065
South Euclid, OH 44121-4128

Mailing address

1611 S Green Rd
Suite 065
South Euclid, OH 44121-4128
Phone (216) 291-9171

Other identifiers 1

IdentifierTypeStateIssuer
0932307MedicaidOH

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
I20061214000250 OH Practitioner - Internal Medicine 8628077906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Menorah Park Center for Senior LivingGroup PAC ID 3577469444, 79 clinicians
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

27100 Cedar Rd
Beachwood, OH 44122-1109

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35063951OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Nov 6, 2017 Accepting new patients
The Cleveland Clinic Foundation Past Accepting new patients

Locations

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

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942216676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 S GREEN RD",
            "address_2": "SUITE 065",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441214128",
            "telephone_number": "216-291-9171",
            "fax_number": "216-291-1827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 S GREEN RD",
            "address_2": "SUITE 065",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441214128",
            "telephone_number": "216-291-9171",
            "fax_number": "216-291-1827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJOSEPH",
        "first_name": "DEBRA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35063951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0932307",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Euclid, OH

Sources for this page

Verify at the official NPI Registry.