Individual provider Active NPI

Justin Weibel

  • Physician Assistant
  • Columbus, OH
National Provider Identifier
1003699554
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1581 Dodd Dr FL 1
Columbus, OH 43210-1257
Phone
(614) 293-2101
Fax
(614) 293-9155
NPI assigned
Aug 17, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OH Primary

Addresses

Primary practice location

1581 Dodd Dr FL 1
Columbus, OH 43210-1257

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-0205

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240124000647 OH Practitioner - Physician Assistant 8729430913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercy College, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osu Surgery, LLCGroup PAC ID 0941105266, 207 clinicians

Practice addresses (Care Compare)

2050 Kenny Rd
Columbus, OH 43221-3502
Phone (614) 366-6675

410 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-3230

450 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-3230

452 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-5502

460 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-2101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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.

NPI Registry JSON

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

{
    "created_epoch": "1692230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1003699554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-0205",
            "fax_number": "614-257-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1581 DODD DR FL 1",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101257",
            "telephone_number": "614-293-2101",
            "fax_number": "614-293-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIBEL",
        "first_name": "JUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-17",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.