Individual provider Active NPI

Timothy L Smullen, MD

  • Vascular & Interventional Radiology Physician
  • Columbus, OH
National Provider Identifier
1376500298
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
35088108 Issued in OH
Practice address
410 W 10TH Ave
Columbus, OH 43210-1240
Phone
(614) 293-8315
Fax
(614) 293-6935
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 35088108 OH
Vascular & Interventional Radiology Physician 2085R0204X 35088108 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) 293-8315

Other practice location 1

793 W State St
Columbus, OH 43222-1551
Phone (614) 234-5100

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
I20060801000119 OH Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 5890708226 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Ohio State University College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osu Radiology LLCGroup PAC ID 8921031675, 180 clinicians
Radiology IncGroup PAC ID 1658274543, 56 clinicians

Practice addresses (Care Compare)

395 W 12TH Ave
RM 460
Columbus, OH 43210-1267
Phone (614) 293-8315

793 W State St
Columbus, OH 43222-1551
Phone (614) 234-5100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.62 of 100Reported as group
Quality
75.91
Improvement activities
40
Cost
82.89

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35088108OHMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osu Radiology LLC Diagnostic Radiology CurrentSince Jul 1, 2025 Accepting new patients
Radiology Inc Diagnostic Radiology CurrentSince Jul 1, 2006 Accepting new patients

Locations

793 W State St
Columbus, OH 43222
Phone (614) 234-1862

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

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

395 W 12th Ave
Rm 460
Columbus, OH 43210
Phone (614) 293-8299

Dept L647
Columbus, OH 43260

10330 Sawmill Pkwy
Ste 500
Powell, OH 43065
Phone (614) 234-0522

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 6

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1376500298",
    "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": "614-293-8315",
            "fax_number": "614-293-6935"
        },
        {
            "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": "614-293-8315",
            "fax_number": "614-293-6935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "793 W State St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432221551",
            "country_code": "US",
            "telephone_number": "614-234-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMULLEN",
        "first_name": "TIMOTHY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35088108",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "OH",
            "license": "35088108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.