Individual provider Active NPI

Michael D Waluzak, M.D.

  • Internal Medicine Physician
  • Westerville, OH
National Provider Identifier
1053394601
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35-04-7306 Issued in OH
Practice address
400 Altair Pkwy Ste 3300
Westerville, OH 43082-7653
Phone
(614) 882-0708
Fax
(614) 882-2878
NPI assigned
Nov 28, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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 35-04-7306 OH Primary

Addresses

Primary practice location

400 Altair Pkwy Ste 3300
Westerville, OH 43082-7653

Mailing address

400 Altair Pkwy Ste 3300
Westerville, OH 43082-7653
Phone (614) 882-0708

Other identifiers 1

IdentifierTypeStateIssuer
0555055MedicaidOH

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
I20100104000506 OH Practitioner - Internal Medicine 0749321404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Ohio Primary Care Physicians, Inc.Group PAC ID 2769383785, 487 clinicians

Practice addresses (Care Compare)

625 Africa Rd
Westerville, OH 43082-0002

Hospital & facility affiliations

  • Grant Medical Center Hospital, Columbus, OH, CCN 360017

Merit-based Incentive Payment System (MIPS)

Final score
87.04 of 100Reported as group
Quality
85.5
Improvement activities
40
Cost
83.38

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Primary Care Physicians, Inc. Internal Medicine CurrentSince Jan 1, 1997 Accepting new patients
Central Ohio Primary Care Physicians Inc Current Accepting new patients
Central Ohio Primary Care Physicians, Inc. CurrentSince Jan 1, 1997 Accepting new patients

Locations

4885 Olentangy River Rd
Columbus, OH 43214
Phone (614) 326-5665

291 W Schrock Rd
Ste B
Westerville, OH 43081
Phone (614) 776-5750

400 Altair Pkwy
Ste 3300
Westerville, OH 43082
Phone (614) 383-6000

555 W Schrock Rd
Westerville, OH 43081
Phone (614) 882-0708

555 W Schrock Rd
Ste 110
Westerville, OH 43081
Phone (614) 500-2500

655 Africa Rd
Westerville, OH 43082

Interoperability endpoints

  • Direct secure messaging: mwaluzak18911@copcp.medicity.net

Organizations & group practices 3

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": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1053394601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 ALTAIR PKWY STE 3300",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430827653",
            "telephone_number": "614-882-0708",
            "fax_number": "614-882-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 ALTAIR PKWY STE 3300",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430827653",
            "telephone_number": "614-882-0708",
            "fax_number": "614-882-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALUZAK",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-04-7306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0555055",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerville, OH

Sources for this page

Verify at the official NPI Registry.