Individual provider Active NPI

Brenda Jeanne Sickle-Santanello, MD

  • Surgical Oncology Physician
  • Columbus, OH
National Provider Identifier
1548259492
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
35050732 Issued in OH
Practice address
170 Northwoods Blvd Ste 210
Columbus, OH 43235-4711
Phone
(614) 505-7511
Fax
(614) 505-7512
NPI assigned
Oct 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X 35050732 OH Primary

Addresses

Primary practice location

170 Northwoods Blvd Ste 210
Columbus, OH 43235-4711

Mailing address

170 Northwoods Blvd Ste 210
Columbus, OH 43235-4711
Phone (614) 505-7511

Other identifiers 1

IdentifierTypeStateIssuer
0696573MedicaidOH

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
I20080211000838 OH Practitioner - General SurgeryPractitioner - Surgical Oncology 9739122565 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Surgical Oncology
Education
Ohio State University College of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osup Community Outreach LLCGroup PAC ID 5799008082, 147 clinicians

Practice addresses (Care Compare)

210 N Main St
London, OH 43140-1115
Phone (740) 845-7000

6100 N Hamilton Rd
Westerville, OH 43081-2062
Phone (614) 293-4969

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision36
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35050732OHMDSurgical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osup Community Outreach LLC CurrentSince Aug 9, 2023 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

210 N Main St
London, OH 43140
Phone (740) 845-7343

6100 N Hamilton Rd
Westerville, OH 43081
Phone (614) 814-8100

Interoperability endpoints

  • Direct secure messaging: bsicklesantanello219441@direct.osumc.edu

Organizations & group practices 3

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": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1548259492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 NORTHWOODS BLVD STE 210",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432354711",
            "telephone_number": "614-505-7511",
            "fax_number": "614-505-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 NORTHWOODS BLVD STE 210",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432354711",
            "telephone_number": "614-505-7511",
            "fax_number": "614-505-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SICKLE-SANTANELLO",
        "first_name": "BRENDA",
        "middle_name": "JEANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "OH",
            "license": "35050732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0696573",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.