Individual provider Active NPI

Jorge Arzola, M.D.

  • Urology Physician
  • Fort Wayne, IN
National Provider Identifier
1205856382
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
01053421A Issued in IN
Practice address
11141 Parkview Plaza Dr Ste 320
Fort Wayne, IN 46845-1714
Phone
(260) 425-5400
NPI assigned
Jul 20, 2006
Last updated
Jan 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 35121647 OH
Urology Physician 208800000X 01053421A IN Primary
Military Health Care Provider 171000000X 01053421A IN

Addresses

Primary practice location

11141 Parkview Plaza Dr Ste 320
Fort Wayne, IN 46845-1714

Mailing address

3737 Southern Blvd Ste 4200
Kettering, OH 45429-0135
Phone (937) 294-1489

Other practice location 1

10 Southmoor Cir NW
Kettering, OH 45429-2486
Phone (937) 294-1489

Other identifiers 1

IdentifierTypeStateIssuer
0087483MedicaidOH

Other names 1

  • Dr. Jorge Arzola Marrero Other name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jarzola161291@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

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
I20130917000753 OH Practitioner - Urology 1951557750 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
State University of New York at Buffalo School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

3535 Pentagon Blvd
Beavercreek, OH 45431-1705

3535 Pentagon Park Blvd
Suite 400
Dayton, OH 45431-1705
Phone (937) 490-2264

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8646

3737 Southern Blvd
Suite 4200
Kettering, OH 45429-0135
Phone (937) 294-1489

4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309

4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01053421AINMDUrology Physician
35121647OHMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Feb 1, 2020 Accepting new patients
Ohiohealth Corporation CurrentSince Feb 1, 2020 Accepting new patients
Wood Health Company LLC CurrentSince Apr 19, 2017 Accepting new patients
Kettering Independent Medical Group Inc CurrentSince Dec 29, 2022 Accepting new patients

Locations

75 Hospital Dr
Ste 250
Athens, OH 45701
Phone (740) 566-4621

3535 Pentagon Blvd
Ste 320
Beavercreek, OH 45431
Phone (937) 490-2270

745 Haskins Rd
Ste B
Bowling Green, OH 43402
Phone (419) 373-7607

950 W Wooster St
Bowling Green, OH 43402
Phone (419) 354-8900

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

141 N Keyser Ave
Deshler, OH 43516
Phone (419) 278-2065

3737 Southern Blvd
Ste 4200
Kettering, OH 45429
Phone (937) 813-7348

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

4000 Miamisburg Centerville Rd
Ste 435
Miamisburg, OH 45342
Phone (937) 384-4511

825 N Main St
Ste 130
Springboro, OH 45066
Phone (937) 401-7583

825 N Main St
Ste 230
Springboro, OH 45066
Phone (866) 224-9472

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: jarzola420940@ecommunitydirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1205856382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 SOUTHERN BLVD STE 4200",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454290135",
            "telephone_number": "937-294-1489",
            "fax_number": "937-297-6468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11141 PARKVIEW PLAZA DR STE 320",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451714",
            "telephone_number": "260-425-5400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Southmoor Cir NW",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454292486",
            "country_code": "US",
            "telephone_number": "937-294-1489",
            "fax_number": "937-297-6468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARZOLA",
        "first_name": "JORGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "35121647",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IN",
            "license": "01053421A",
            "primary": true
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "IN",
            "license": "01053421A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0087483",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jarzola161291@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3737 Southern Blvd Ste 4200",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454290135",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3737 Southern Blvd Ste 4200",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454290135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JORGE",
            "last_name": "ARZOLA MARRERO",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.