Individual provider Active NPI

Alexandra Pelaez, MD

  • Family Medicine Physician
  • Marysville, OH
National Provider Identifier
1104238930
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.131715 Issued in OH
Practice address
17853 State Route 31
Marysville, OH 43040-8520
Phone
(937) 578-4004
Fax
(937) 578-4024
NPI assigned
May 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.131715 OH Primary

Addresses

Primary practice location

17853 State Route 31
Marysville, OH 43040-8520

Mailing address

17853 State Route 31
Marysville, OH 43040-8520
Phone (937) 578-4004

Other names 1

  • Alexandra Smith Former name

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
I20170829004190 OH Practitioner - Family Practice 5496078719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Union County Physician CorporationGroup PAC ID 1557419173, 105 clinicians

Practice addresses (Care Compare)

388 Damascus Rd
Marysville, OH 43040-5535
Phone (937) 578-2626

Hospital & facility affiliations

  • Gem City Home Care Home health agency, Dublin, OH, CCN 368184
  • Memorial Hospital Hospital, Marysville, OH, CCN 360092
  • Dublin Methodist Hospital Hospital, Dublin, OH, CCN 360348
  • James Cancer Hospital & Solove Research Institute Hospital, Columbus, OH, CCN 360242

Merit-based Incentive Payment System (MIPS)

Final score
83.33 of 100Reported as group
Quality
68.93
Promoting interoperability
100
Improvement activities
40
Cost
75.49

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Union County Physician Corporation CurrentSince Oct 1, 2017 Accepting new patients
Union County Physician Corporation CurrentSince Oct 1, 2017 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

17853 State Route 31
Marysville, OH 43040
Phone (937) 578-4200

388 Damascus Rd
Marysville, OH 43040
Phone (937) 578-2626

17853 State Route 31
Ste B
Marysville, OH 43040
Phone (937) 578-4004

480 S Jefferson Ave
Ste 400
Plain City, OH 43064
Phone (614) 570-3598

480 S Jefferson Ave
Ste 500
Plain City, OH 43064
Phone (614) 873-3434

Interoperability endpoints

  • Direct secure messaging: asmith13376@direct.osumc.edu

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": "1401235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1104238930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17853 STATE ROUTE 31",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430408520",
            "telephone_number": "937-578-4004",
            "fax_number": "937-578-4024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17853 STATE ROUTE 31",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430408520",
            "telephone_number": "937-578-4004",
            "fax_number": "937-578-4024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELAEZ",
        "first_name": "ALEXANDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-28",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.131715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "SMITH",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marysville, OH

Sources for this page

Verify at the official NPI Registry.