Individual provider Active NPI

Diane L Gorgas, M.D.

  • Emergency Medicine Physician
  • Columbus, OH
National Provider Identifier
1346320306
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35062961 Issued in OH
Practice address
410 W 10TH Ave
Columbus, OH 43210-1240
Phone
(614) 293-8305
Fax
(614) 293-3124
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician 207PE0005X 35062961 OH
Emergency Medicine Physician 207P00000X 35062961 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) 293-8305

Other identifiers 2

IdentifierTypeStateIssuer
0993519MedicaidOH
311229292OtherOHGROUP FEDERAL TAX ID#

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
I20100923000944 OH Practitioner - Emergency Medicine 5395659981 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osu Emergency Medicine LLCGroup PAC ID 2668386673, 169 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

  • Ohio State University State Health System Hospital, Columbus, OH, CCN 360085

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35062961OHMDUndersea and Hyperbaric Medicine (Emergency Medicine) Physician

Practice roles

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

Locations

700 Ackerman Rd
Ste 540
Columbus, OH 43202

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

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

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

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 and National Provider Directory roles.

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1346320306",
    "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": "614-293-8305",
            "fax_number": "614-293-3124"
        },
        {
            "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": "GORGAS",
        "first_name": "DIANE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "OH",
            "license": "35062961",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35062961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0993519",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP FEDERAL TAX ID#",
            "identifier": "311229292",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.