Individual provider Active NPI

Shiva Rangwani, MD, MBA

  • Student in an Organized Health Care Education/Training Program
  • Columbus, OH
National Provider Identifier
1417577917
Registry record updated Jul 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
57.249200 Issued in OH
Practice address
The Ohio State University Wexner Medical Center
395 W 12TH Ave. 3Rd Floor
Columbus, OH 43210
Phone
(614) 293-3989
Fax
(614) 293-9789
NPI assigned
Apr 24, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 57.249200 OH
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X 57.249200 OH Primary

Addresses

Primary practice location

The Ohio State University Wexner Medical Center
395 W 12TH Ave. 3Rd Floor
Columbus, OH 43210

Mailing address

The Ohio State University Wexner Medical Center
395 W 12TH Avenue, Third Floor
Columbus, OH 43210-8984
Phone (614) 293-3989

Other practice location 1

3640 Colonel Glenn Hwy
Dayton, OH 45435-0001
Phone (614) 378-8711

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200612002432 OH Order and Referring Only - Internal MedicinePractitioner - Internal MedicinePractitioner - Plastic and Reconstructive Surgery 3072935444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Ohio State University Wexner Medical Center Student in an Organized Health Care Education/Training Program CurrentSince Jun 3, 2025 Accepting new patients

Locations

395 W 12th Ave
Fl Third
Columbus, OH 43210

Interoperability endpoints

  • Direct secure messaging: shiva.rangwani@upmcdirect.com
  • Direct secure messaging: shiva.rangwani.1@19222.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1587686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1417577917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER",
            "address_2": "395 W 12TH AVENUE, THIRD FLOOR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432108984",
            "telephone_number": "614-293-3989",
            "fax_number": "614-293-9789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER",
            "address_2": "395 W 12TH AVE. 3RD FLOOR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43210",
            "telephone_number": "614-293-3989",
            "fax_number": "614-293-9789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3640 Colonel Glenn Hwy",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454350001",
            "country_code": "US",
            "telephone_number": "614-378-8711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANGWANI",
        "first_name": "SHIVA",
        "name_prefix": "Dr.",
        "credential": "MD, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-24",
        "last_updated": "2021-07-16",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "OH",
            "license": "57.249200",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "57.249200",
            "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 Jul 16, 2021; 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.