Individual provider Active NPI

Alvin D. Pelt, M.D.

  • Psychiatry Physician
  • Columbus, OH
National Provider Identifier
1093890550
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35 05 8245 Issued in OH
Practice address
134 Northwoods Blvd
Suite B-1
Columbus, OH 43235-4727
Phone
(614) 846-6611
Fax
(614) 846-6662
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35 05 8245 OH Primary

Addresses

Primary practice location

134 Northwoods Blvd
Suite B-1
Columbus, OH 43235-4727

Mailing address

134 Northwoods Blvd
Suite B-1
Columbus, OH 43235-4727
Phone (614) 846-6611

Other identifiers 1

IdentifierTypeStateIssuer
0782032MedicaidOH

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
I20170531001127 OH Practitioner - Addiction Medicine 0446154553

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35 05 8245OHMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1093890550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 NORTHWOODS BLVD",
            "address_2": "SUITE B-1",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432354727",
            "telephone_number": "614-846-6611",
            "fax_number": "614-846-6662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 NORTHWOODS BLVD",
            "address_2": "SUITE B-1",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432354727",
            "telephone_number": "614-846-6611",
            "fax_number": "614-846-6662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELT",
        "first_name": "ALVIN",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35 05 8245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0782032",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.