Individual provider Active NPI

Colleen M Cebulla, MD

  • Retina Specialist (Ophthalmology) Physician
  • Columbus, OH
National Provider Identifier
1144264334
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
35093413 Issued in OH
Practice address
915 Olentangy River Rd
Columbus, OH 43212-3153
Phone
(614) 293-8116
Fax
(614) 293-5315
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Retina Specialist (Ophthalmology) Physician 207WX0107X 35093413 OH Primary

Addresses

Primary practice location

915 Olentangy River Rd
Columbus, OH 43212-3153

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-8116

Other identifiers 1

IdentifierTypeStateIssuer
2995666MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ccebulla8250@direct.osumc.edu

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
I20091008000109 OH Practitioner - Ophthalmology 1658375753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Ohio State University College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osu Eye Physicians and Surgeons, LLCGroup PAC ID 5698671881, 45 clinicians

Practice addresses (Care Compare)

915 Olentangy River Rd
FL 5
Columbus, OH 43212-3153
Phone (614) 293-8116

Hospital & facility affiliations

  • Ohio State University State Health System Hospital, Columbus, OH, CCN 360085
  • James Cancer Hospital & Solove Research Institute Hospital, Columbus, OH, CCN 360242

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35093413OHMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osu Eye Physicians and Surgeons LLC Ophthalmology CurrentSince Sep 1, 2009 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
University of Miami Past Accepting new patients

Locations

700 Ackerman Rd
Ste 570
Columbus, OH 43202
Phone (614) 293-2046

300 W 10th Ave
Fl 4
Columbus, OH 43210
Phone (614) 293-8074

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

915 Olentangy River Rd
Columbus, OH 43212

915 Olentangy River Rd
Fl 5
Columbus, OH 43212

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1144264334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-8116",
            "fax_number": "614-293-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 OLENTANGY RIVER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432123153",
            "telephone_number": "614-293-8116",
            "fax_number": "614-293-5315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEBULLA",
        "first_name": "COLLEEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "OH",
            "license": "35093413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2995666",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccebulla8250@direct.osumc.edu",
            "affiliation": "N",
            "address_1": "915 Olentangy River Rd",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432123153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.