NPIMap

Organization Active NPI

Mid-Ohio Emergency Services, LLC

Doing business as Moes

  • Emergency Medicine Physician
  • Columbus, OH
National Provider Identifier
1386691780
Registry record updated Jun 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
MID-OHIO EMERGENCY SERVICES, LLC
Doing business as
Moes
Practice address
111 S Grant Ave
Columbus, OH 43215-4701
Phone
(614) 566-9000
Fax
(614) 566-8072
NPI assigned
May 30, 2006
Last updated
Jun 18, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2020

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

Authorized official

Name
Gregory Decker, M.D.NPI 1669427159
Title
President
Phone
(800) 424-3672

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

111 S Grant Ave
Columbus, OH 43215-4701

Mailing address

1643 NW 136TH Ave Ste 100
Sunrise, FL 33323-2857
Phone (800) 424-3672

Other identifiers 8

IdentifierTypeStateIssuer
365758500OtherOHUS DEPT OF LABOR
020304100OtherOHFEDERAL BLACK LUNG
CI6323OtherOHMEDICARE TRAVELERS RR - G
2099107MedicaidOH
2099116MedicaidOH
020208900OtherFEDERAL BLACK LUNG PROGRA
365758501OtherOHUS DEPT OF LABOR
000000066092OtherOHANTHEM OHIO

Other names 1

  • MOES Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031231000569 OH Part B Supplier - Clinic/Group Practice 8921907601 Receives reassigned benefits from 194 practitioners
Practice locations: Powell, OH; Westerville, OH; Reynoldsburg, OH; Pickerington, OH; Obetz, OH; Hilliard, OH; Dublin, OH; Canal Winchester, OH…

National Provider Directory

National Provider Directory

Locations

111 S Grant Ave
Columbus, OH 43215
Phone (614) 461-3232

6708 Perimeter Loop Rd
Dublin, OH 43017
Phone (614) 544-8000

3880 Fishinger Blvd
Hilliard, OH 43026
Phone (614) 788-9310

5868 N Hamilton Rd
New Albany, OH 43054
Phone (614) 788-9350

Practitioners & affiliated clinicians

Practitioners 310

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 310

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592438400000",
    "number": "1386691780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1643 NW 136TH AVE STE 100",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232857",
            "telephone_number": "800-424-3672",
            "fax_number": "954-377-3042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S GRANT AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432154701",
            "telephone_number": "614-566-9000",
            "fax_number": "614-566-8072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-OHIO EMERGENCY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-30",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A",
        "authorized_official_last_name": "DECKER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-424-3672",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "365758500",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "020304100",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE TRAVELERS RR - G",
            "identifier": "CI6323",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2099107",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2099116",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG PROGRA",
            "identifier": "020208900",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "365758501",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM OHIO",
            "identifier": "000000066092",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MOES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 18, 2020; 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.