NPIMap

Organization Active NPI

Central Ohio Urology Group, LLC

  • Urology Physician
  • Gahanna, OH
National Provider Identifier
1396780466
Registry record updated Dec 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
CENTRAL OHIO UROLOGY GROUP, LLC
Practice address
701 Tech Center Drive
Suite 100
Gahanna, OH 43230
Phone
(614) 396-2684
Fax
(614) 396-2480
NPI assigned
Jun 20, 2006
Last updated
Dec 31, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2018

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

Authorized official

Name
Mrs. Nicole Giacomelli, M.B.A.
Title
Director of Operations
Phone
(614) 396-2635

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X NU Primary

Addresses

Primary practice location

701 Tech Center Drive
Suite 100
Gahanna, OH 43230

Mailing address

701 Tech Center Drive
Suite 250
Gahanna, OH 43230
Phone (614) 944-4806

Other identifiers 6

IdentifierTypeStateIssuer
2660820MedicaidOH
1518136605OtherOHDMERC
1144499237OtherOHDMERC
DF0566OtherOHRAILROAD MEDICARE
1083883391OtherOHDMERC
1811166986OtherOHDMERC

Other names 1

  • Group & UA Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060731000201 OH Part B Supplier - Clinic/Group Practice 5395758882 Receives reassigned benefits from 65 practitioners
Practice locations: Mount Vernon, OH; Mt Gilead, OH; Pastaskala, OH; Pickerington, OH; Gahanna, OH; Westerville, OH; Worthington, OH; Hilliard, OH…

National Provider Directory

National Provider Directory

Locations

701 Tech Center Dr
Ste 120
Gahanna, OH 43230

Practitioners & affiliated clinicians

Practitioners 72

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 72

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546214400000",
    "number": "1396780466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 TECH CENTER DRIVE",
            "address_2": "SUITE 250",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "43230",
            "telephone_number": "614-944-4806",
            "fax_number": "614-944-4750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 TECH CENTER DRIVE",
            "address_2": "SUITE 100",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "43230",
            "telephone_number": "614-396-2684",
            "fax_number": "614-396-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL OHIO UROLOGY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2018-12-31",
        "status": "A",
        "authorized_official_last_name": "GIACOMELLI",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "614-396-2635",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.B.A."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2660820",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "1518136605",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "1144499237",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF0566",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "1083883391",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "1811166986",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Group & UA",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Group & UA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gahanna, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2018; 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.