Individual provider Active NPI

Jeanie Zsambok, PHD

  • Psychologist
  • Columbus, OH
National Provider Identifier
1053648857
Registry record updated Nov 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
5367 Issued in OH
Practice address
4624 Sawmill Rd
Columbus, OH 43220-2247
Phone
(614) 459-4490
Fax
(614) 457-3656
NPI assigned
Nov 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 5367 OH Primary

Addresses

Primary practice location

4624 Sawmill Rd
Columbus, OH 43220-2247

Mailing address

4624 Sawmill Rd
Columbus, OH 43220-2247
Phone (614) 459-4490

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131227000471 OH Practitioner - Clinical Psychologist 0244467033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4624 Sawmill Rd
Columbus, OH 43220-2247
Phone (614) 459-4490

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5367OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Ohio, Inc. CurrentSince Apr 1, 2024 Accepting new patients
Optum Behavioral Care of Ohio, Inc CurrentSince Apr 1, 2024 Accepting new patients
Optum Behavioral Care of Ohio, Inc Current Accepting new patients

Locations

4624 Sawmill Rd
Columbus, OH 43220
Phone (614) 457-4490

3055 Kettering Blvd
Ste 218
Moraine, OH 45439
Phone (937) 813-1292

Interoperability endpoints

  • Direct secure messaging: jeanie.zsambok.1@28621.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1258329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258329600000",
    "number": "1053648857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4624 SAWMILL RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202247",
            "telephone_number": "614-459-4490",
            "fax_number": "614-457-3656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4624 SAWMILL RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202247",
            "telephone_number": "614-459-4490",
            "fax_number": "614-457-3656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZSAMBOK",
        "first_name": "JEANIE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-16",
        "last_updated": "2009-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "5367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.