Individual provider Active NPI

Lerato Denise Modiselle, APRN-CNP

  • Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1578445243
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.0038168 Issued in OH
Practice address
520 W 10TH Ave
Columbus, OH 43210-1328
Phone
(614) 293-2101
Fax
(614) 293-9155
NPI assigned
Jul 23, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN.CNP.0038168 OH
Nurse Practitioner 363L00000X APRN.CNP.0038168 OH Primary

Addresses

Primary practice location

520 W 10TH Ave
Columbus, OH 43210-1328

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-2101

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
I20250912004260 OH Practitioner - Nurse Practitioner 3779086848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

700 Ackerman Rd
Columbus, OH 43202-1500

700 Ackerman Rd
Suite 2120
Columbus, OH 43202-1559

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0038168OHMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Osu Internal Medicine, LLC CurrentSince Sep 1, 2025 Accepting new patients

Locations

460 W 10th Ave
Columbus, OH 43210
Phone (614) 293-3196

520 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

3900 Stoneridge Ln
Dublin, OH 43017
Phone (614) 366-5001

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1753228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1578445243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-2101",
            "fax_number": "614-293-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 W 10TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101328",
            "telephone_number": "614-293-2101",
            "fax_number": "614-293-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODISELLE",
        "first_name": "LERATO",
        "middle_name": "DENISE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-23",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "APRN.CNP.0038168",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.0038168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.