Brendan Divis

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

35-136764 Issued in OH

Practice address

3400 Olentangy River Rd
Columbus, OH 43202-1523

Phone

(614) 754-5500

Fax

(614) 754-5501

NPI assigned

Jun 1, 2015

Last updated

Nov 3, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Anesthesiology

Education

Northeastern Ohio University College of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ohio Gastroenterology Group, Inc.Group PAC ID 0143211284, 118 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

78.34 of 100Reported as group

Quality

59.66

Promoting interoperability

99

Improvement activities

40

Cost

68.99

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ohio Gastroenterology Group, Inc.

  • Gastroenterology Physician
  • Columbus, OH
  • NPI 1124197637
  Medicare reassignment Care Compare group NPD
• Licking Memorial Professional Corp.

  dba Licking Memorial Pediatrics-Utica

  • Pediatrics Physician
  • Utica, OH
  • NPI 1497771521
  NPD (past)

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1104206564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 OLENTANGY RIVER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021523",
            "telephone_number": "614-754-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 OLENTANGY RIVER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021523",
            "telephone_number": "614-754-5500",
            "fax_number": "614-754-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVIS",
        "first_name": "BRENDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-01",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35-136764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ohio.gastro@directaddress.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3400 Olentangy River Rd",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432021523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Divine Interventions Home Health, LLC
• Divine Solutions Healthcare LLC
• Divine Steps Health Care, LLC (DODD Waiver)
• Divine Steps Medical Transportation
• Divinity Home Healthcare
• Sequoia Dixon Woodward
• Alexandra Elizabeth Dixon
• Beverly Dixon
• Brian L Dixon Sr.
• Brooke Dixon, CPNP-PC

• Anesthesiology Physician in Columbus, OH
• Providers in Columbus, OH by specialty
• Anesthesiology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.