Kelley J. Zyniewicz, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

35061741 Issued in OH

Practice address

430 Altair Pkwy Ste 210
Westerville, OH 43082-7647

Phone

(614) 898-7546

Fax

(614) 794-4294

NPI assigned

May 15, 2006

Last updated

Feb 23, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 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

Specialty

Dermatology

Education

Michigan State University College of Human Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Ohio Skin and Cancer IncGroup PAC ID 4688608870, 11 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Merit-based Incentive Payment System (MIPS)

Final score

54.58 of 100Reported as group

Quality

18.57

Promoting interoperability

99

Improvement activities

0

Cost

73.81

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kzyniewicz357828@direct.osumc.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Central Ohio Skin & Cancer Inc

  • Dermatology Physician
  • Westerville, OH
  • NPI 1922016864
  Medicare reassignment Care Compare group NPD
• Central Ohio Skin & Cancer Inc

  • Dermatology Physician
  • Sunbury, OH
  • NPI 1083622930
  NPD
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • 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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1568413375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 ALTAIR PKWY STE 210",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430827647",
            "telephone_number": "614-898-7546",
            "fax_number": "614-293-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 ALTAIR PKWY STE 210",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430827647",
            "telephone_number": "614-898-7546",
            "fax_number": "614-794-4294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "540 Officenter Pl Ste 240",
            "address_purpose": "LOCATION",
            "city": "Gahanna",
            "state": "OH",
            "postal_code": "432305317",
            "country_code": "US",
            "telephone_number": "614-293-1707",
            "fax_number": "614-293-1716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZYNIEWICZ",
        "first_name": "KELLEY",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35061741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0845116",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kzyniewicz357828@direct.osumc.edu",
            "affiliation": "N",
            "address_1": "540 Officenter Pl Ste 240",
            "city": "Gahanna",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432305317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gretchen Raymond Zody, DDS
• Abigail Ione Zolla
• Hannah Zoller
• Yingting Zou
• Courtney Zybat, ED.S., M.A.

• Dermatology Physician in Westerville, OH
• Providers in Westerville, OH by specialty
• Dermatology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.