Lauren Michelle Bandwen, PAC
Individual provider Active NPI Physician Assistant · Berea, OH
NPI 1487539201 · NPPES record last updated Nov 4, 2025
Key facts
- NPI
- 1487539201
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 50.009575RX (OH)
- Practice address
- 275 Eastland Rd
Berea, OH 44017-2005 - Phone
- (330) 546-4912
- NPI assigned
- Aug 11, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Osup Community Outreach LLC
Practice addresses (Care Compare)
6100 N Hamilton Rd
Westerville, OH 43081-2062
Phone (614) 293-4969
Hospital & facility affiliations
- Ohio State University State Health System
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251126000189 | OH | Practitioner - Physician Assistant | 3274025200 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1236985 | OH | MD | Physician Assistant |
| 50.009575RX | OH | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osup Community Outreach LLC | Current |
Accepting new patients | |
| Osu General Internal Medicine LLC | Past | Accepting new patients |
Locations
700 Ackerman Rd
Ste 2120
Columbus, OH 43202
1075 Beecher Xing N
Ste A
Gahanna, OH 43230
Phone (614) 366-6886
1957 Ohio Dr
Grove City, OH 43123
Phone (614) 366-5671
1025 Refugee Rd
Fl 2
Pickerington, OH 43147
Phone (614) 293-8617
6100 N Hamilton Rd
Westerville, OH 43081
Phone (614) 814-8100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 50.009575RX | OH | Yes |
| Physician Assistant | 363A00000X | 1236985 | OH |
Addresses
Primary practice location
275 Eastland Rd
Berea, OH 44017-2005
Mailing address
700 Ackerman Rd Ste 2120
Suite 2120
Columbus, OH 43202-1559
Phone (614) 366-6886
Other practice location 1
1075 Beecher Xing N Ste A
Gahanna, OH 43230-4572
Phone (614) 366-6886
Other providers in Berea, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.