Individual provider Active NPI

Jessica Amie Kaffenberger, M.D.

  • Dermatology Physician
  • Columbus, OH
National Provider Identifier
1588977912
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
35123270 Issued in OH
Practice address
540 Office Center PL
Suite 240
Columbus, OH 43230-5317
Phone
(614) 293-1707
Fax
(614) 293-1716
NPI assigned
Jul 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 35123270 OH Primary

Addresses

Primary practice location

540 Office Center PL
Suite 240
Columbus, OH 43230-5317

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-1707

Other names 1

  • Jessica Amie Yankura Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jkaffenberger250386@direct.osumc.edu

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
I20140729002517 OH Practitioner - Dermatology 7113143066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Pennsylvania State University College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osu Internal Medicine LLCGroup PAC ID 5496651408, 1,141 clinicians

Practice addresses (Care Compare)

540 Officenter PL
Gahanna, OH 43230-5317
Phone (614) 293-1707

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision21
Removal of skin lesions306
Removal or shaving of skin growth54
Skin biopsy79

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35123270OHMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osu Internal Medicine, LLC Dermatology CurrentSince Jun 10, 2014 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

700 Ackerman Rd
Ste 570
Columbus, OH 43202
Phone (614) 293-2046

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

540 Officenter Pl
Gahanna, OH 43230

540 Officenter Pl
Ste 240
Gahanna, OH 43230
Phone (614) 688-9542

Interoperability endpoints

  • Direct secure messaging: jkaffenberger250386@direct.osumc.edu

Organizations & group practices 2

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 4

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": "1279065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1588977912",
    "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": "614-293-1707",
            "fax_number": "614-293-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 OFFICE CENTER PL",
            "address_2": "SUITE 240",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432305317",
            "telephone_number": "614-293-1707",
            "fax_number": "614-293-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAFFENBERGER",
        "first_name": "JESSICA",
        "middle_name": "AMIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-14",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35123270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkaffenberger250386@direct.osumc.edu",
            "affiliation": "N",
            "address_1": "540 Office Center Pl",
            "address_2": "Suite 240",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432305317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "YANKURA",
            "middle_name": "AMIE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.