Individual provider Active NPI

Dustin R Ford, PA-C

  • Physician Assistant
  • Columbus, OH
National Provider Identifier
1124378492
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.003576 Issued in OH
Practice address
5150 E Dublin Granville Rd Ste 110
Columbus, OH 43081-8804
Phone
(614) 775-9870
NPI assigned
Sep 14, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.003576 OH Primary

Addresses

Primary practice location

5150 E Dublin Granville Rd Ste 110
Columbus, OH 43081-8804

Mailing address

PO Box 7527
Dublin, OH 43017-0727

Other identifiers 1

IdentifierTypeStateIssuer
0074257MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dford39890@direct.ohiohealth.com OhioHealth Urgent Care LLC

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121002000291 OH Practitioner - Physician Assistant 0941459259 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth Urgent Care LLCGroup PAC ID 3476733700, 129 clinicians
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

2014 Baltimore Reynoldsburg Rd
Reynoldsburg, OH 43068-3261
Phone (614) 522-6900

2030 Stringtown Rd
Grove City, OH 43123-3993
Phone (614) 883-0160

265 W Union St
Athens, OH 45701-2313

393 E Town St
Columbus, OH 43215-4799

6905 Hospital Dr
Suite 130
Dublin, OH 43016-9600
Phone (614) 923-0300

895 W 3Rd Ave
Columbus, OH 43212-3106
Phone (614) 437-0278

Merit-based Incentive Payment System (MIPS)

Final score
86.16 of 100Reported as group
Quality
79.15
Promoting interoperability
100
Improvement activities
40
Cost
74.72

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.003576OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Valley Physicians Inc CurrentSince Feb 1, 2020 Accepting new patients
Ohiohealth Corporation CurrentSince Sep 1, 2020 Accepting new patients
Ohiohealth Corporation CurrentSince Sep 1, 2020 Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

936 State Route 160
Gallipolis, OH 45631
Phone (740) 446-4600

2030 Stringtown Rd
Grove City, OH 43123
Phone (614) 566-0987

500 London Ave
Marysville, OH 43040
Phone (740) 420-8451

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1124378492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727",
            "fax_number": "614-544-6370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 E DUBLIN GRANVILLE RD STE 110",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "430818804",
            "telephone_number": "614-775-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "DUSTIN",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-14",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0074257",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dford39890@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Urgent Care LLC",
            "address_1": "5150 E Dublin Granville Rd Ste 110",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430818804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.