Individual provider Active NPI

Connor Bradly Prusz, PA-C

  • Physician Assistant
  • Dublin, OH
National Provider Identifier
1467059808
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.006854RX Issued in OH
Practice address
6670 Perimeter Drive
Ste 140
Dublin, OH 43016-8057
Phone
(614) 526-2150
Fax
(614) 526-2151
NPI assigned
Oct 8, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PENDING OH
Physician Assistant 363A00000X 50.006854RX OH Primary

Addresses

Primary practice location

6670 Perimeter Drive
Ste 140
Dublin, OH 43016-8057

Mailing address

6670 Perimeter Drive
Ste 140
Dublin, OH 43016-8057
Phone (614) 526-2150

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210202003323 OH Practitioner - Physician Assistant 2769896737 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantage Orthopedics IncGroup PAC ID 2668842964, 2 clinicians

Practice addresses (Care Compare)

6670 Perimeter Dr
Suite 140
Dublin, OH 43016-8057
Phone (614) 526-2150

7000 Bordeaux CT
Dublin, OH 43016-6121

Hospital & facility affiliations

  • Dublin Methodist Hospital Hospital, Dublin, OH, CCN 360348

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PENDINGOHMDVascular Neurology Physician
50.006854RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Feb 1, 2021 Accepting new patients
Ohiohealth Corporation CurrentSince Feb 1, 2021 Accepting new patients

Locations

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

111 S Grant Ave
Ste 350
Columbus, OH 43215
Phone (614) 566-9160

Dept L3652
Columbus, OH 43260

6670 Perimeter Dr
Ste 140
Dublin, OH 43016
Phone (614) 526-2150

5450 Frantz Rd
Ste 360
Dublin, OH 43016
Phone (614) 533-6497

103 Commerce Park Dr
Ste A
Westerville, OH 43082
Phone (614) 545-4414

Organizations & group practices 4

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 1

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": "1602115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1467059808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6670 PERIMETER DRIVE",
            "address_2": "STE 140",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430168057",
            "telephone_number": "614-526-2150",
            "fax_number": "614-526-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6670 PERIMETER DRIVE",
            "address_2": "STE 140",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430168057",
            "telephone_number": "614-526-2150",
            "fax_number": "614-526-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUSZ",
        "first_name": "CONNOR",
        "middle_name": "BRADLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-08",
        "last_updated": "2025-03-20",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.006854RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

Verify at the official NPI Registry.