Individual provider Active NPI

Diana V. Hennessy, M.D.

  • Internal Medicine Physician
  • Columbus, OH
National Provider Identifier
1275852618
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.121010 Issued in OH
Practice address
3555 Olentangy River Rd Ste 1080
Columbus, OH 43214-3984
Phone
(614) 268-8164
Fax
(614) 268-8406
NPI assigned
May 25, 2010
Last updated
Jul 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.121010 OH Primary

Addresses

Primary practice location

3555 Olentangy River Rd Ste 1080
Columbus, OH 43214-3984

Mailing address

3555 Olentangy River Rd Ste 1080
Columbus, OH 43214-3984
Phone (614) 268-8164

Other identifiers 1

IdentifierTypeStateIssuer
0087542MedicaidOH

Other names 1

  • Dr. Diana V. Golub Former name

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
I20130917000483 OH Practitioner - Internal Medicine 8527209865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Louisville School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4885 Olentangy River Rd
Columbus, OH 43214-1952
Phone (614) 326-5665

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.04 of 100Reported as group
Quality
85.5
Improvement activities
40
Cost
83.38

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Primary Care Physicians, Inc. Internal Medicine CurrentSince Aug 1, 2018 Accepting new patients
Central Ohio Primary Care Physicians Inc Current Accepting new patients
Central Ohio Primary Care Physicians, Inc. CurrentSince Aug 1, 2018 Accepting new patients
Mount Carmel Health System Past Accepting new patients
Mount Carmel Health System Past Accepting new patients

Locations

1430 S High St
Columbus, OH 43207
Phone (614) 255-6930

3525 Olentangy River Rd
Ste 4330
Columbus, OH 43214
Phone (614) 255-6930

3535 Olentangy River Rd
Columbus, OH 43214
Phone (614) 566-1997

3555 Olentangy River Rd
Ste 1080
Columbus, OH 43214
Phone (614) 268-8164

4885 Olentangy River Rd
Columbus, OH 43214
Phone (614) 326-5665

655 Africa Rd
Westerville, OH 43082

Interoperability endpoints

  • Direct secure messaging: dhennessy18917@copcp.medicity.net

Organizations & group practices 5

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 3

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": "1274745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1275852618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 OLENTANGY RIVER RD STE 1080",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143984",
            "telephone_number": "614-268-8164",
            "fax_number": "614-268-8406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 OLENTANGY RIVER RD STE 1080",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143984",
            "telephone_number": "614-268-8164",
            "fax_number": "614-268-8406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNESSY",
        "first_name": "DIANA",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-25",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.121010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0087542",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "GOLUB",
            "middle_name": "V.",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.