NPIMap

Individual provider Active NPI

Alexander Campolo, D.O.

  • Adult Medicine Physician
  • Newark, OH
National Provider Identifier
1306230255
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
34013240 Issued in OH
Practice address
1930 Tamarack Rd
Newark, OH 43055-2303
Phone
(740) 522-7600
Fax
(740) 522-9777
NPI assigned
Mar 27, 2015
Last updated
Oct 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Adult Medicine Physician 207QA0505X 34013240 OH Primary

Addresses

Primary practice location

1930 Tamarack Rd
Newark, OH 43055-2303

Mailing address

1930 Tamarack Rd
Newark, OH 43055-2303
Phone (740) 522-7600

Other practice location 1

3595 Olentangy River Road
Riverside Community Medicine
Columbus, OH 43214-3998
Phone (614) 566-5456

Other practice location 2

3595 Olentangy River Road
Riverside Community Medicine
Columbus, OH 43214-3998
Phone (614) 566-5456

Other practice location 3

4605 Duke Dr Ste 220
Mason, OH 45040-1553
Phone (614) 441-9300 ext. 61609

Other identifiers 1

IdentifierTypeStateIssuer
0241035MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180724001736 OH Practitioner - Internal Medicine 4587973748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ohio University, College of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical and Surgical Associates IncGroup PAC ID 5890760938, 9 clinicians

Practice addresses (Care Compare)

1930 Tamarack Rd
Newark, OH 43055-2303
Phone (740) 522-7600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.61 of 100Reported as group
Quality
97.53
Improvement activities
40
Cost
68.67

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34013240OHMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical and Surgical Associates Inc CurrentSince Jul 16, 2018 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1930 Tamarack Rd
Newark, OH 43055
Phone (740) 344-6901

Interoperability endpoints

  • Direct secure messaging: acampolo@masai-oh.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

Hospital & facility affiliations 8

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": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1306230255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 TAMARACK RD",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430552303",
            "telephone_number": "740-522-7600",
            "fax_number": "740-522-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 TAMARACK RD",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430552303",
            "telephone_number": "740-522-7600",
            "fax_number": "740-522-9777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3595 Olentangy River Road",
            "address_2": "Riverside Community Medicine",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432143998",
            "country_code": "US",
            "telephone_number": "614-566-5456",
            "fax_number": "614-566-6902",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3595 Olentangy River Road",
            "address_2": "Riverside Community Medicine",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432143998",
            "country_code": "US",
            "telephone_number": "614-566-5456",
            "fax_number": "614-566-6902",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4605 Duke Dr Ste 220",
            "address_purpose": "LOCATION",
            "city": "Mason",
            "state": "OH",
            "postal_code": "450401553",
            "country_code": "US",
            "telephone_number": "614-441-9300 x61609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPOLO",
        "first_name": "ALEXANDER",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-27",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "OH",
            "license": "34013240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0241035",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.