Individual provider Active NPI

Blaize Obrien, MD

  • Otolaryngology Physician
  • Columbus, OH
National Provider Identifier
1104826379
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
35.076493 Issued in OH
Practice address
974 Bethel Rd Ste a
Columbus, OH 43214-2467
Phone
(614) 538-2424
Fax
(614) 538-2418
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 35.076493 OH Primary

Addresses

Primary practice location

974 Bethel Rd Ste a
Columbus, OH 43214-2467

Mailing address

1810 Mackenzie Dr FL 2
Columbus, OH 43220-2967
Phone (614) 273-2250

Other identifiers 1

IdentifierTypeStateIssuer
2227736MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address 974bethelent@1047.direct.myezyaccess.com

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
I20080423000026 OH Practitioner - Otolaryngology 9830289586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Ohio State University College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Otolaryngologists IncGroup PAC ID 7719881960, 59 clinicians

Practice addresses (Care Compare)

974 Bethel Rd
Suite a
Columbus, OH 43214-2467
Phone (614) 538-2424

Hospital & facility affiliations

  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006
  • Grant Medical Center Hospital, Columbus, OH, CCN 360017
  • Dublin Methodist Hospital Hospital, Dublin, OH, CCN 360348

Merit-based Incentive Payment System (MIPS)

Final score
90.51 of 100Reported as group
Quality
92.35
Promoting interoperability
88
Improvement activities
40
Cost
86.01

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Otolaryngologists Inc Otolaryngology CurrentSince Jan 1, 2008 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1810 Mackenzie Dr
Fl 2
Columbus, OH 43220
Phone (614) 273-2250

6573 E Broad St
Ste A
Columbus, OH 43213
Phone (614) 755-5151

974 Bethel Rd
Ste A
Columbus, OH 43214
Phone (614) 538-2422

477 Cooper Rd
Ste 480
Westerville, OH 43081
Phone (614) 293-4238

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": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1104826379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 MACKENZIE DR FL 2",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202967",
            "telephone_number": "614-273-2250",
            "fax_number": "614-273-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "974 BETHEL RD STE A",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432142467",
            "telephone_number": "614-538-2424",
            "fax_number": "614-538-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBRIEN",
        "first_name": "BLAIZE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "35.076493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2227736",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "974bethelent@1047.direct.myezyaccess.com",
            "affiliation": "N",
            "address_1": "974 Bethel Rd Ste A",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432142467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.