Active NPI
Benjamin Kuttikatt Poulose, MD
- Surgery Physician
- Columbus, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 35089610
- Practice address
- 1800 Zollinger Rd
Columbus, OH 43221-2849 - Phone
- (614) 293-3230
- Fax
- (614) 293-4030
- NPI assigned
- Jan 4, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 35089610 | OH | Primary |
Addresses
Primary practice location
1800 Zollinger Rd
Columbus, OH 43221-2849
Mailing address
700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-3230
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0302346 | Medicaid | OH |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bpoulose643258@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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Johns Hopkins University School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2050 Kenny Rd
Columbus, OH 43221-3502
Phone (614) 366-6675
7567 Central Parke Blvd
Mason, OH 45040-6852
Hospital & facility affiliations
- Ohio State University State Health System
- James Cancer Hospital & Solove Research Institute
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hernia repair - groin (open) | 23 |
| Hernia repair (minimally invasive) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35089610 | OH | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osu Surgery, LLC | Surgery | Current | Accepting new patients |
| Lima Memorial Joint Operating Company | Past | Accepting new patients | |
| Ohio State University Hospitals | Past | Accepting new patients |
Locations
2050 Kenny Rd
Columbus, OH 43221
Phone (614) 293-8054
300 W 10th Ave
Fl 4
Columbus, OH 43210
Phone (614) 293-8074
700 Ackerman Rd
Ste 570
Columbus, OH 43202
Phone (614) 293-2046
700 Ackerman Rd
Ste 2120
Columbus, OH 43202
1800 Zollinger Rd
Upper Arlington, OH 43221
Phone (614) 293-2130
1800 Zollinger Rd
Fl 3
Upper Arlington, OH 43221
Phone (614) 293-2130
Interoperability endpoints
- bpoulose643258@direct.osumc.edu
Organizations & group practices 4
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.
-
- Surgery Physician
- Columbus, OH
- NPI 1538117551
-
- Physical Therapist
- Mason, OH
- NPI 1326126061
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
-
- General Acute Care Hospital
- Columbus, OH
- NPI 1447359997
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Special Hospital
- Columbus, OH
- NPI 1124127683
-
- Rehabilitation Hospital Unit
- Columbus, OH
- NPI 1184723637
-
- General Acute Care Hospital
- Columbus, OH
- NPI 1447359997
-
- Psychiatric Hospital Unit
- Columbus, OH
- NPI 1790876183
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612483200000",
"number": "1194872986",
"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": "614-293-3230",
"fax_number": "614-293-4030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 ZOLLINGER RD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432212849",
"telephone_number": "614-293-3230",
"fax_number": "614-293-4030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POULOSE",
"first_name": "BENJAMIN",
"middle_name": "KUTTIKATT",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-04",
"last_updated": "2021-02-05",
"certification_date": "2021-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "OH",
"license": "35089610",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0302346",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "bpoulose643258@direct.osumc.edu",
"affiliation": "N",
"address_1": "1800 Zollinger Rd",
"city": "Columbus",
"state": "OH",
"country_code": "US",
"postal_code": "432212849",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.