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Individual provider Active NPI

Elmer F Diltz Jr., DO

  • Family Medicine Physician
  • Columbus, OH
National Provider Identifier
1104877042
Registry record updated Aug 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34003331 Issued in OH
Practice address
4254 E Main St
Columbus, OH 43213
Phone
(614) 235-9944
Fax
(614) 235-9344
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2012

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 34003331 OH Primary

Addresses

Primary practice location

4254 E Main St
Columbus, OH 43213

Mailing address

4254 E Main St
Columbus, OH 43213
Phone (614) 235-9944

Other identifiers 1

IdentifierTypeStateIssuer
0538574MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100929000006 OH Practitioner - Family Practice 8820114721 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio University, College of Osteopathic Medicine, 1981
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Buckeye ClinicGroup PAC ID 7810237666, 11 clinicians
Whitehall Medical Center IncGroup PAC ID 6103850086, 3 clinicians

Practice addresses (Care Compare)

3121 W Broad St
Columbus, OH 43204-1306
Phone (614) 534-1100

4254 E Main St
Columbus, OH 43213-3031
Phone (614) 235-9944

Hospital & facility affiliations

  • Mount Carmel Home Care Home health agency, Columbus, OH, CCN 367273
  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006
  • Mount Carmel East & West Hospital, Columbus, OH, CCN 360035
  • Ohio State University State Health System Hospital, Columbus, OH, CCN 360085
  • Licking Memorial Hospital Hospital, Newark, OH, CCN 360218

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Buckeye Clinic CurrentSince Jun 1, 2024 Accepting new patients
Whitehall Medical Center Inc CurrentSince Mar 1, 1993 Accepting new patients
Buckeye Clinic Family Medicine Current Accepting new patients

Locations

3121 W Broad St
Columbus, OH 43204
Phone (614) 274-6100

6805 Avery Muirfield Dr
Ste 103
Dublin, OH 43016
Phone (614) 534-1100

4254 E Main St
Whitehall, OH 43213
Phone (614) 235-9944

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 9

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345766400000",
    "number": "1104877042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4254 E MAIN ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43213",
            "telephone_number": "614-235-9944",
            "fax_number": "614-235-9344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4254 E MAIN ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43213",
            "telephone_number": "614-235-9944",
            "fax_number": "614-235-9344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILTZ",
        "first_name": "ELMER",
        "middle_name": "F",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2012-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34003331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0538574",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.