Individual provider Active NPI

Mark J. Conroy, M.D.

  • Emergency Medicine Physician
  • Columbus, OH
National Provider Identifier
1295021954
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35126038 Issued in OH
Practice address
410 W 10TH Ave
Columbus, OH 43210-1240
Phone
(614) 293-8305
Fax
(614) 293-3124
NPI assigned
Jun 21, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Emergency Medicine) Physician 207PS0010X 35126038 OH
Emergency Medicine Physician 207P00000X 35126038 OH Primary

Addresses

Primary practice location

410 W 10TH Ave
Columbus, OH 43210-1240

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-2046

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mconroy343670@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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150730012283 OH Practitioner - Emergency Medicine 8123255395 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Albany Medical College of Union University, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osu Internal Medicine LLCGroup PAC ID 5496651408, 1,141 clinicians
Osu Emergency Medicine LLCGroup PAC ID 2668386673, 169 clinicians
Osu Observation Medicine, LLCGroup PAC ID 3375692270, 423 clinicians

Practice addresses (Care Compare)

2835 Fred Taylor Dr
Columbus, OH 43202-1552
Phone (614) 293-2663

3900 Stoneridge LN
Dublin, OH 43017-2288
Phone (614) 366-5001

410 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-8305

450 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-8000

452 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-8000

460 W 10TH Ave
Columbus, OH 43210-1240
Phone (800) 293-5066

920 N Hamilton Rd
Gahanna, OH 43230-1757
Phone (614) 293-2663

Hospital & facility affiliations

  • Ohio State University State Health System Hospital, Columbus, OH, CCN 360085
  • James Cancer Hospital & Solove Research Institute Hospital, Columbus, OH, CCN 360242

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35126038OHMDSports Medicine (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osu Internal Medicine, LLC CurrentSince Jul 1, 2022 Accepting new patients
Osu Observation Medicine, LLC Emergency Medicine CurrentSince Jul 1, 2019 Accepting new patients
Osu Emergency Medicine LLC CurrentSince Jul 1, 2015 Accepting new patients

Locations

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

2050 Kenny Rd
Ste 3100
Columbus, OH 43221
Phone (614) 293-2432

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

700 Ackerman Rd
Ste 570
Columbus, OH 43202
Phone (614) 293-2046

3900 Stoneridge Ln
Dublin, OH 43017
Phone (614) 366-5001

920 N Hamilton Rd
Ste 600
Gahanna, OH 43230
Phone (614) 293-7600

6515 Pullman Dr
Ste 1100
Lewis Center, OH 43035
Phone (614) 293-7160

1450 Columbus Ave
Wshngtn Ct Hs, OH 43160
Phone (740) 335-2654

1450 Columbus Ave
Ste 103
Wshngtn Ct Hs, OH 43160
Phone (740) 333-2243

1450 Columbus Ave
Ste 106
Wshngtn Ct Hs, OH 43160
Phone (614) 766-2006

Organizations & group practices 3

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 4

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": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1295021954",
    "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": "614-293-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W 10TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101240",
            "telephone_number": "614-293-8305",
            "fax_number": "614-293-3124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONROY",
        "first_name": "MARK",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-21",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "OH",
            "license": "35126038",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35126038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mconroy343670@direct.osumc.edu",
            "affiliation": "N",
            "address_1": "410 W 10th Ave",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432101240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.