Individual provider Active NPI

Obiajulu Hans Iwenofu, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Columbus, OH
National Provider Identifier
1073678140
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
35090387 Issued in OH
Practice address
410 W 10TH Ave
Columbus, OH 43210
Phone
(614) 293-5905
Fax
(614) 293-4715
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 35090387 OH Primary

Addresses

Primary practice location

410 W 10TH Ave
Columbus, OH 43210

Mailing address

700 Ackerman Rd Ste 570
Columbus, OH 43202-1579
Phone (614) 293-0308

Other identifiers 1

IdentifierTypeStateIssuer
2803283MedicaidOH

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
I20071212000639 OH Practitioner - Pathology 8628168804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osu Pathology Services, LLCGroup PAC ID 4587569983, 62 clinicians

Practice addresses (Care Compare)

2121 Kenny Rd
FL 3
Columbus, OH 43210-3100
Phone (614) 814-9223

410 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-5905

450 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-5905

452 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-5905

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35090387OHMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osu Pathology Services LLC Current Accepting new patients
Osu Pathology Services, LLC CurrentSince Sep 1, 2007 Accepting new patients

Locations

410 W 10th Ave
#E403
Columbus, OH 43210
Phone (614) 293-5905

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

500 London Ave
Marysville, OH 43040
Phone (740) 420-8451

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": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1073678140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 570",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021579",
            "telephone_number": "614-293-0308",
            "fax_number": "614-293-4715"
        },
        {
            "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": "43210",
            "telephone_number": "614-293-5905",
            "fax_number": "614-293-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWENOFU",
        "first_name": "OBIAJULU",
        "middle_name": "HANS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OH",
            "license": "35090387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2803283",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.