Individual provider Active NPI

Nseobong I Ntukidem, MD

  • Medical Oncology Physician
  • Columbus, OH
National Provider Identifier
1447474523
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
35.087793 Issued in OH
Practice address
810 Jasonway Ave Ste a
Columbus, OH 43214-4359
Phone
(614) 442-3130
Fax
(614) 442-3145
NPI assigned
Apr 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 35.087793 OH Primary

Addresses

Primary practice location

810 Jasonway Ave Ste a
Columbus, OH 43214-4359

Mailing address

810 Jasonway Ave Ste a
Columbus, OH 43214-4359
Phone (614) 442-3130

Other practice location 1

300 Polaris Pkwy Ste 330
Westerville, OH 43082-7989
Phone (614) 442-3130

Other practice location 2

6700 Perimeter Dr
Dublin, OH 43016-8063
Phone (614) 442-3130

Other identifiers 1

IdentifierTypeStateIssuer
2609574MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nse.ntukidem@coha.ikm.direct-ci.com Direct Columbus Oncology Associates Inc

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
I20080729000397 OH Practitioner - Medical Oncology 8426048802 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Columbus Oncology Associates IncGroup PAC ID 8224088877, 25 clinicians

Practice addresses (Care Compare)

810 Jasonway Ave
Suite a
Columbus, OH 43214-4359
Phone (614) 442-3130

Hospital & facility affiliations

  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006
  • Grant Medical Center Hospital, Columbus, OH, CCN 360017
  • Dublin Methodist Hospital Hospital, Dublin, OH, CCN 360348
  • Grady Memorial Hospital Hospital, Delaware, OH, CCN 360210
  • Mount Carmel St Ann'S Hospital, Westerville, OH, CCN 360012

Merit-based Incentive Payment System (MIPS)

Final score
79.2 of 100Reported as group
Quality
80.17
Promoting interoperability
100
Improvement activities
40
Cost
43.97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.087793OHMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation Hematology & Oncology CurrentSince Dec 1, 2010 Accepting new patients
Ohiohealth Corporation CurrentSince Dec 1, 2010 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Indiana Hemophilia & Thrombosis Center, Inc. Hematology & Oncology Past Accepting new patients
Department of State Health Services Past Accepting new patients
Midland County Hospital District Past Accepting new patients

Locations

Dept L3652
Columbus, OH 43260

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

300 Polaris Pkwy
Ste 330
Westerville, OH 43082
Phone (614) 442-3130

Interoperability endpoints

  • Direct secure messaging: nse.ntukidem@coha.ikm.direct-ci.com
  • Direct secure messaging: nntukidem4480739@direct.trinity-health.org

Organizations & group practices 7

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1447474523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 JASONWAY AVE STE A",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432144359",
            "telephone_number": "614-442-3130",
            "fax_number": "614-442-3150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 JASONWAY AVE STE A",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432144359",
            "telephone_number": "614-442-3130",
            "fax_number": "614-442-3145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Polaris Pkwy Ste 330",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430827989",
            "country_code": "US",
            "telephone_number": "614-442-3130",
            "fax_number": "614-442-3145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6700 Perimeter Dr",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "OH",
            "postal_code": "430168063",
            "country_code": "US",
            "telephone_number": "614-442-3130",
            "fax_number": "614-442-3145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NTUKIDEM",
        "first_name": "NSEOBONG",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "OH",
            "license": "35.087793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2609574",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nse.ntukidem@coha.ikm.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Columbus Oncology Associates Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "810 Jasonway Ave Ste A",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432144359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.