NPIMap

Organization Active NPI

Osu Plastic Surgery LLC

  • Plastic Surgery Physician
  • Columbus, OH
National Provider Identifier
1346533734
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
OSU PLASTIC SURGERY LLC
Practice address
915 Olentangy River Rd Ste 2140
Columbus, OH 43212-3153
Phone
(614) 293-8566
Fax
(614) 293-3381
NPI assigned
May 18, 2011
Last updated
Mar 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Authorized official

Name
Dr. Amy M. Moore, MDNPI 1538381462
Title
Department Chair
Phone
(614) 293-7656

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X Primary
Surgery of the Hand (Plastic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2082S0105X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Surgical Critical Care PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0102X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X

Addresses

Primary practice location

915 Olentangy River Rd Ste 2140
Columbus, OH 43212-3153

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-8566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111208000164 OH Part B Supplier - Clinic/Group Practice 2961677679 Receives reassigned benefits from 46 practitioners
Practice locations: Columbus, OH; Westerville, OH; New Albany, OH; Dublin, OH

National Provider Directory

National Provider Directory

Locations

1145 Olentangy River Rd
Ste 2200
Columbus, OH 43212
Phone (614) 293-0223

181 Taylor Ave
Fl 13181
Columbus, OH 43203

2 Easton Oval
Columbus, OH 43219
Phone (614) 475-9500

2 Easton Oval
Ste 545
Columbus, OH 43219
Phone (614) 864-6220

2050 Kenny Rd
Ste 1222
Columbus, OH 43221
Phone (614) 366-6675

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

700 Childrens Dr
#T5
Columbus, OH 43205

915 Olentangy River Rd
Ste 1000
Columbus, OH 43212
Phone (614) 293-2090

6100 N Hamilton Rd
Fl 1
Westerville, OH 43081

Practitioners & affiliated clinicians

Practitioners 47

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1305676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1346533734",
    "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": "614-293-8566",
            "fax_number": "614-293-3381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 OLENTANGY RIVER RD STE 2140",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432123153",
            "telephone_number": "614-293-8566",
            "fax_number": "614-293-3381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSU PLASTIC SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-18",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "DEPARTMENT CHAIR",
        "authorized_official_telephone_number": "614-293-7656",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgical Critical Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.