Tedros Andom, M.D.
Individual provider Active NPI Surgery Physician · Springfield, OH
NPI 1629160262 · NPPES record last updated Mar 17, 2018
Key facts
- NPI
- 1629160262
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- 35091693 (OH)
- Practice address
- 2253 Olympic St
Springfield, OH 45503-2736 - Phone
- (937) 717-4884
- Fax
- (937) 717-6207
- NPI assigned
- Sep 29, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 8
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- General Surgery
- Education
- University of Louisville School of Medicine, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy Health Physicians Springfield Specialty Care LLC
Practice addresses (Care Compare)
100 W McCreight Ave
Suite 110
Springfield, OH 45504-1890
Phone (937) 717-4884
Hospital & facility affiliations
- Springfield Regional Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Spinal fusion | 1-10 |
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 11 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080908000395 | OH | Practitioner - General Surgery | 4587764287 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health Physicians Cincinnati LLC | Current |
Accepting new patients | |
| Mercy Health Physicians Springfield Specialty Care LLC | Surgery | Current |
Accepting new patients |
| Mercy Health Physicians Cincinnati, LLC | Surgery | Current |
Accepting new patients |
| Ohio Valley Medical Center, LLC | Current | Accepting new patients | |
| Springfield Regional Outpatient Surgery Center LLC | Past |
Accepting new patients | |
| Breckinridge Health, Inc. | Past | Accepting new patients | |
| Community Mercy Health Partners | Past | Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Locations
1701 Mercy Health Pl
Cincinnati, OH 45237
Phone (513) 952-5000
2446 Kipling Ave
Cincinnati, OH 45239
Phone (513) 583-8500
2253 Olympic St
Springfield, OH 45503
Phone (937) 717-4884
100 W McCreight Ave
Ste 110
Springfield, OH 45504
Phone (937) 523-9940
100 W McCreight Ave
Fl 1
Springfield, OH 45504
Phone (937) 323-1404
900 Scioto St
Urbana, OH 43078
Phone (937) 652-1834
900 Scioto St
Ste 1
Urbana, OH 43078
Phone (937) 653-4666
900 Scioto St
Ste 6
Urbana, OH 43078
Phone (937) 323-7340
Interoperability endpoints
- tandom@direct.ovsurgical.com
- tandom7391@direct.bsmhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 35091693 | OH | Yes |
Addresses
Primary practice location
2253 Olympic St
Springfield, OH 45503-2736
Mailing address
2253 Olympic St
Springfield, OH 45503-2736
Phone (937) 717-4884
Other practice location 1
2624 Lexington Ave
Suite 340
Springfield, OH 45505-2607
Phone (937) 717-4884
Other practice location 2
2624 Lexington Ave
Suite 340
Springfield, OH 45505-2607
Phone (937) 717-4884
Other practice location 3
900 Scioto St Ste 1
Urbana, OH 43078-2251
Phone (937) 717-4884
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2850571 | Medicaid | OH |
Other providers in Springfield, OH
- Michelle Anders
- April Dawn Anderson
- Lorrenzo L Anderson
- Ronnie Lee Anderson
- Shylynn Izbella Anderson
- Mary Susan Andorfer
- Ronda Lea Andorfer
- Angel Nation LLC
- Joseph H. Angles
- Robin Anglin
All providers in Springfield, OH · Surgery Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.