Osu Plastic Surgery LLC

Organization Active NPI Plastic Surgery Physician · Columbus, OH

NPI 1346533734 · NPPES record last updated Mar 4, 2024

Key facts

NPI
1346533734
Entity type
Organization (NPI type 2)
Primary specialty
Plastic Surgery Physician 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
Organization subpart
No

Authorized official

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

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

Practitioners 46

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 46

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH

Medicare enrollment records

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

Locations

915 Olentangy River Rd
Fl 2
Columbus, OH 43212

700 Childrens Dr
#T5
Columbus, OH 43205

915 Olentangy River Rd
Columbus, OH 43212

181 Taylor Ave
Fl 13181
Columbus, OH 43203

7706 Olentangy River Rd
Columbus, OH 43235
Phone (614) 366-8175

4830 Knightsbridge Blvd
Ste G
Columbus, OH 43214
Phone (614) 488-8000

543 Taylor Ave
Columbus, OH 43203
Phone (614) 685-3333

6515 Pullman Dr
Lewis Center, OH 43035
Phone (614) 688-7140

6100 N Hamilton Rd
Fl 1
Westerville, OH 43081

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208200000X Yes
Surgery of the Hand (Plastic Surgery) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2082S0105X
Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208600000X
Surgical Critical Care Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2086S0102X
Physician Assistant
Group: 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

Other identifiers

IdentifierTypeStateIssuer
DS4045OtherOHRAILROAD MEDICARE
0053309MedicaidOH

Other providers in Columbus, OH

All providers in Columbus, OH · Plastic Surgery Physician in Ohio

Sources for this page

Verify at the official NPI Registry.