Individual provider Active NPI

Marc Evan Serve, D.O.

  • Family Medicine Physician
  • Columbus, OH
National Provider Identifier
1013300425
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34.013369 Issued in OH
Practice address
1120 Polaris Pkwy Ste 200
Columbus, OH 43240
Phone
(614) 880-9333
Fax
(614) 880-9333
NPI assigned
Mar 9, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34.013369 OH Primary

Addresses

Primary practice location

1120 Polaris Pkwy Ste 200
Columbus, OH 43240

Mailing address

1120 Polaris Pkwy Ste 200
Columbus, OH 43240-4042
Phone (614) 880-9333

Other identifiers 1

IdentifierTypeStateIssuer
0291007MedicaidOH

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
I20180711003133 OH Practitioner - Family Practice 6507112133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1120 Polaris Pkwy
Suite 200
Columbus, OH 43240-4042
Phone (614) 880-9333

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Primary Care Physicians Inc Current Accepting new patients

Locations

655 Africa Rd
Westerville, OH 43082

Interoperability endpoints

  • Direct secure messaging: mserve18799@copcp.medicity.net

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1425859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1013300425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 POLARIS PKWY STE 200",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432404042",
            "telephone_number": "614-880-9333",
            "fax_number": "614-880-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 POLARIS PKWY STE 200",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43240",
            "telephone_number": "614-880-9333",
            "fax_number": "614-880-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERVE",
        "first_name": "MARC",
        "middle_name": "EVAN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-09",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.013369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0291007",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.