Individual provider Active NPI

Hermon H Ghebremedhin

  • Medical Physician Assistant
  • Columbus, OH
National Provider Identifier
1588344923
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
50.008142RX Issued in OH
Practice address
4832 W Broad St
Columbus, OH 43228-1971
Phone
(614) 465-7457
NPI assigned
Jul 20, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 50.008142RX OH Primary
Physician Assistant 363A00000X C0010201 MD

Addresses

Primary practice location

4832 W Broad St
Columbus, OH 43228-1971

Mailing address

754 Tatra CT
Reynoldsburg, OH 43068-4755
Phone (614) 743-5699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230908001053 OH Practitioner - Physician Assistant 4880058957 Reassigns benefits to 4 organizations
I20251201002873 DC Practitioner - Physician Assistant 4880058957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians
Incare Health Solutions LLCGroup PAC ID 5092980730, 66 clinicians

Practice addresses (Care Compare)

3535 Olentangy River Rd
Columbus, OH 43214-3908

3840 Main St
Hilliard, OH 43026-1450
Phone (614) 319-3030

393 E Town St
Columbus, OH 43215-4799

Hospital & facility affiliations

  • Holy Cross Hospital Hospital, Silver Spring, MD, CCN 210004
  • Holy Cross Germantown Hospital Hospital, Germantown, MD, CCN 210065
  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0010201MDMDPhysician Assistant
50.008142RXOHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC Physician Assistant CurrentSince Dec 9, 2025 Accepting new patients
Cep America LLC Current Accepting new patients
Ohiohealth Corporation CurrentSince Feb 1, 2024 Accepting new patients
Cep America LLC CurrentSince Nov 18, 2025 Accepting new patients
Incare Health Solutions, LLC Physician Assistant CurrentSince Jul 24, 2023 Accepting new patients
Cep America LLC CurrentSince Nov 18, 2025 Accepting new patients
Md1Stop Primary Care PastSince Aug 17, 2025 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2041 Georgia Ave NW
Washington, DC 20060
Phone (202) 865-3785

65 N Waggoner Rd
Blacklick, OH 43004
Phone (614) 604-8805

4135 Tuscarawas St W
Canton, OH 44708
Phone (330) 546-0913

4832 W Broad St
Columbus, OH 43228
Phone (614) 465-7457

175 S 3rd St
Ste 200
Columbus, OH 43215
Phone (267) 817-8902

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

1085 Polaris Pkwy
Columbus, OH 43240
Phone (614) 505-0021

7450 State Route 161 E
Plain City, OH 43064
Phone (614) 504-5002

2562 W Market St
Tiffin, OH 44883
Phone (567) 938-8008

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: hghebremedhin4722853@direct.trinity-health.org

Organizations & group practices 10

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 5

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": "1689811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1588344923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "754 TATRA CT",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430684755",
            "telephone_number": "614-743-5699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4832 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432281971",
            "telephone_number": "614-465-7457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHEBREMEDHIN",
        "first_name": "HERMON",
        "middle_name": "H",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-20",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.008142RX",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0010201",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.