Individual provider Active NPI

Tina M Pawlikowski, OD

  • Optometrist
  • Columbus, OH
National Provider Identifier
1285628420
Registry record updated Jun 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046008944 Issued in IL
Practice address
338 W 10TH Ave
Columbus, OH 43210-1280
Phone
(773) 520-0992
Fax
(740) 879-3458
NPI assigned
Sep 2, 2005
Last updated
Jun 7, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046008944 IL Primary

Addresses

Primary practice location

338 W 10TH Ave
Columbus, OH 43210-1280

Mailing address

338 W 10TH Ave
Columbus, OH 43210-1280
Phone (773) 520-0992

Other identifiers 1

IdentifierTypeStateIssuer
046008944MedicaidIL

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100512000259 OH Practitioner - Optometry 5799813739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio State UniversityGroup PAC ID 6103866207, 42 clinicians

Practice addresses (Care Compare)

1664 Neil Ave
Columbus, OH 43201-2333
Phone (614) 292-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046008944ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio State University Optometrist CurrentSince Mar 22, 2010 Accepting new patients
Ohio State University CurrentSince Mar 22, 2010 Accepting new patients

Locations

1664 Neil Ave
Columbus, OH 43201
Phone (614) 292-2020

338 W 10th Ave
Columbus, OH 43210
Phone (614) 292-2020

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275868800000",
    "number": "1285628420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 W 10TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101280",
            "telephone_number": "773-520-0992",
            "fax_number": "773-520-0992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 W 10TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101280",
            "telephone_number": "773-520-0992",
            "fax_number": "740-879-3458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAWLIKOWSKI",
        "first_name": "TINA",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-02",
        "last_updated": "2010-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046008944",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.