Individual provider Active NPI

Eric C Bourekas, MD

  • Neuroradiology Physician
  • Columbus, OH
National Provider Identifier
1053362442
Registry record updated Jul 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
35065107 Issued in OH
Practice address
410 W 10TH Ave
Columbus, OH 43210-1240
Phone
(614) 293-8315
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 35065107 OH Primary

Addresses

Primary practice location

410 W 10TH Ave
Columbus, OH 43210-1240

Mailing address

700 Ackerman Rd
Suite 270
Columbus, OH 43202-1559

Other identifiers 1

IdentifierTypeStateIssuer
0927653MedicaidOH

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
I20050928000788 OH Practitioner - Diagnostic Radiology 3072548056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Cincinnati College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osu Radiology LLCGroup PAC ID 8921031675, 180 clinicians

Practice addresses (Care Compare)

395 W 12TH Ave
RM 460
Columbus, OH 43210-1267
Phone (614) 293-8315

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35065107OHMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osu Radiology LLC CurrentSince Oct 1, 2005 Accepting new patients
University Radiologists Inc Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Osu Internal Medicine, LLC Past Accepting new patients

Locations

410 W 10th Ave
Fl 2
Columbus, OH 43210
Phone (614) 247-7707

700 Ackerman Rd
Ste 270
Columbus, OH 43202

395 W 12th Ave
Rm 460
Columbus, OH 43210
Phone (614) 293-8299

700 Ackerman Rd
Ste 570
Columbus, OH 43202
Phone (614) 293-2046

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

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 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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184284800000",
    "number": "1053362442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD",
            "address_2": "SUITE 270",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W 10TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101240",
            "telephone_number": "614-293-8315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUREKAS",
        "first_name": "ERIC",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2007-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "OH",
            "license": "35065107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0927653",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.