Active NPI
Blake Waxman, M.D.
- Family Medicine Physician
- Columbus, OH
National Provider Identifier
1376778944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35.120834
- Practice address
- 420 N James Rd
Columbus, OH 43219-1834 - Phone
- (614) 257-5200
- NPI assigned
- May 26, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35.120834 | OH | Primary |
Addresses
Primary practice location
420 N James Rd
Columbus, OH 43219-1834
Mailing address
3813 S Hamilton Rd
Groveport, OH 43125-9330
Phone (614) 835-0400
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250203002732 | OH | Order and Referring Only - Family Practice | 2567644586 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736726400000",
"number": "1376778944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3813 S HAMILTON RD",
"city": "GROVEPORT",
"state": "OH",
"postal_code": "431259330",
"telephone_number": "614-835-0400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 N JAMES RD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432191834",
"telephone_number": "614-257-5200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAXMAN",
"first_name": "BLAKE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-05-26",
"last_updated": "2025-01-13",
"certification_date": "2025-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "35.120834",
"primary": true
}
],
"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 Jan 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.