Individual provider Active NPI

Alyssa Danielle Drosdak, MD

  • Gastroenterology Physician
  • Newark, OH
National Provider Identifier
1033613500
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
35.150939 Issued in OH
Practice address
1717 West Main St Ste 203
Newark, OH 43055
Phone
(220) 564-2950
Fax
(220) 564-2951
NPI assigned
Mar 20, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 35.150939 OH Primary

Addresses

Primary practice location

1717 West Main St Ste 203
Newark, OH 43055

Mailing address

1717 West Main St Ste 203
Newark, OH 43055
Phone (220) 564-2950

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adrosdak38752@lickingmemorial.medicity.net

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
I20240910000445 OH Practitioner - Gastroenterology 3072845569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Ohio State University College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1717 W Main St
Suite 203
Newark, OH 43055-1362
Phone (220) 564-2950

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.98 of 100Reported as group
Quality
75.66
Promoting interoperability
100
Improvement activities
40
Cost
75.38

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy69
Upper gastrointestinal (GI) endoscopy for acid reflux76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.150939OHMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Licking Memorial Health Professionals CurrentSince Sep 4, 2024 Accepting new patients
Licking Memorial Hospital Current Accepting new patients
Licking Memorial Professional Corporation CurrentSince Sep 4, 2024 Accepting new patients
Licking Memorial Professional Corp. Past Accepting new patients

Locations

1717 W Main St
Apt 203
Newark, OH 43055
Phone (220) 564-2950

120 McMillen Dr
Newark, OH 43055
Phone (220) 564-4806

1320 W Main St
Newark, OH 43055
Phone (740) 348-4151

Interoperability endpoints

  • Direct secure messaging: adrosdak@lickingmemorial.medicity.net

Organizations & group practices 4

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": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1033613500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 WEST MAIN ST STE 203",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "43055",
            "telephone_number": "220-564-2950",
            "fax_number": "220-564-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 WEST MAIN ST STE 203",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "43055",
            "telephone_number": "220-564-2950",
            "fax_number": "220-564-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DROSDAK",
        "first_name": "ALYSSA",
        "middle_name": "DANIELLE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "35.150939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adrosdak38752@lickingmemorial.medicity.net",
            "affiliation": "N",
            "address_1": "1717 West Main St Ste 203",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "43055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.