Jacqueline M Amico, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35-05-8624 Issued in OH

Practice address

3382 Paris Blvd
Westerville, OH 43081-4260

Phone

(614) 882-2521

Fax

(614) 882-0511

NPI assigned

Sep 27, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Central Ohio Primary Care Physicians, Inc.

  • Internal Medicine Physician
  • Westerville, OH
  • NPI 1194705194
  Medicare reassignment
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300060800000",
    "number": "1487640264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3382 PARIS BLVD",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430814260",
            "telephone_number": "614-882-2521",
            "fax_number": "614-882-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3382 PARIS BLVD",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430814260",
            "telephone_number": "614-882-2521",
            "fax_number": "614-882-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMICO",
        "first_name": "JACQUELINE",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-27",
        "last_updated": "2011-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-05-8624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0836920",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• American Eagle Transportation Inc
• American Eagle Transportation Inc
• American Health Network of Ohio, LLC
• American Motherland Home Health Agency LLC
• American Oncology Partners, P.a.
• Morgan Amigo, MD
• Amin Home Health Care LLC
• Aya Amin
• Chaitali Amin
• Milan Amin

• Internal Medicine Physician in Westerville, OH
• Providers in Westerville, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.