Individual provider Active NPI

Roni Lynn Masters, PA-C

  • Surgical Physician Assistant
  • Zanesville, OH
National Provider Identifier
1083043616
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
50.003913 Issued in OH
Practice address
955 Bethesda Dr
Zanesville, OH 43701
Phone
(419) 522-0320
NPI assigned
Nov 4, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X
Surgical Physician Assistant 363AS0400X 50.003913 OH Primary

Addresses

Primary practice location

955 Bethesda Dr
Zanesville, OH 43701

Mailing address

5400 Frantz Rd
Suite 250
Dublin, OH 43016-4144
Phone (614) 544-6356

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151103002550 OH Practitioner - Physician Assistant 9436469442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Medical Group, LLCGroup PAC ID 7719040385, 265 clinicians

Practice addresses (Care Compare)

1246 Ashland Ave
Zanesville, OH 43701-2861

2951 Maple Ave
Zanesville, OH 43701-1406
Phone (740) 454-4000

945 Bethesda Dr
Zanesville, OH 43701-1880

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.003913OHMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Medical Group LLC Single Specialty CurrentSince May 10, 2016 Accepting new patients
Genesis Medical Group, LLC CurrentSince May 10, 2016 Accepting new patients
Genesis Primary Care Physicians LLC Single Specialty Past Accepting new patients

Locations

1246 Ashland Ave
Ste 204
Zanesville, OH 43701
Phone (740) 450-6167

945 Bethesda Dr
Ste 330
Zanesville, OH 43701
Phone (740) 454-4038

955 Bethesda Dr
Zanesville, OH 43701
Phone (740) 454-0804

945 Bethesda Dr
Ste 200
Zanesville, OH 43701
Phone (740) 454-4788

2904 Bell St
Zanesville, OH 43701
Phone (740) 586-6828

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 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": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1083043616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 FRANTZ RD",
            "address_2": "SUITE 250",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430164144",
            "telephone_number": "614-544-6356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 BETHESDA DR",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "43701",
            "telephone_number": "419-522-0320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTERS",
        "first_name": "RONI",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-04",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50.003913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zanesville, OH

Sources for this page

Verify at the official NPI Registry.