Individual provider Active NPI

Timothy Mellish

  • Physician Assistant
  • Columbus, OH
National Provider Identifier
1285056093
Registry record updated Aug 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
003942 Issued in OH
Practice address
793 W State St
Columbus, OH 43222
Phone
(614) 234-5180
NPI assigned
Jan 13, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2018

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 003942 OH Primary

Addresses

Primary practice location

793 W State St
Columbus, OH 43222

Mailing address

793 W State St
Columbus, OH 43222-1551
Phone (614) 234-5180

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
I20140825002166 OH Practitioner - Physician Assistant 0345468831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Primary Care Practices IncGroup PAC ID 3072417534, 1,071 clinicians

Practice addresses (Care Compare)

158 W Main Rd
Conneaut, OH 44030-2039

950 Clague Rd
Suite 104
Westlake, OH 44145-1533
Phone (216) 844-8200

Hospital & facility affiliations

  • Uh Cleveland Medical Center Hospital, Cleveland, OH, CCN 360137
  • University Hospitals - Elyria Medical Center Hospital, Elyria, OH, CCN 360145
  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
003942OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc CurrentSince Jun 30, 2025 Accepting new patients
University Primary Care Practices Inc CurrentSince Jun 30, 2025 Accepting new patients
University Primary Care Practices Past Accepting new patients
University Hospitals Medical Group Inc Past Accepting new patients

Locations

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

5001 Transportation Dr
Ste 201
Sheffield Village, OH 44054
Phone (313) 808-0950

960 Clague Rd
Ste 1200
Westlake, OH 44145
Phone (440) 250-2001

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1389571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533254400000",
    "number": "1285056093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "793 W STATE ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221551",
            "telephone_number": "614-234-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "793 W STATE ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43222",
            "telephone_number": "614-234-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLISH",
        "first_name": "TIMOTHY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-13",
        "last_updated": "2018-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "003942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.