Individual provider Active NPI

Robert John Graessle, DO

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Columbus, OH
National Provider Identifier
1629274139
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X
License
34.009785 Issued in OH
Practice address
815 W Broad St Ste 200
Columbus, OH 43222-1478
Phone
(614) 717-0822
NPI assigned
Jun 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 34009785 OH
Emergency Medicine Physician 207P00000X 5101017440 MI
Psychiatry Physician 2084P0800X 34.009785 OH
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 34.009785 OH Primary

Addresses

Primary practice location

815 W Broad St Ste 200
Columbus, OH 43222-1478

Mailing address

815 W Broad St Ste 200
Columbus, OH 43222-1478
Phone (614) 717-0822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100412000001 OH Practitioner - Emergency Medicine 0244385664
I20200805001854 OH Practitioner - Addiction Medicine 0244385664

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101017440MIMDEmergency Medicine Physician
34009785OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Basecamp Recovery LLC Past Accepting new patients
Ohio Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Flowing Waters Emergency Physicians Emergency Medicine Past Accepting new patients
Basecamp Recovery Center Past Accepting new patients

Organizations & group practices 4

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": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1629274139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 W BROAD ST STE 200",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221478",
            "telephone_number": "614-717-0822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 W BROAD ST STE 200",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221478",
            "telephone_number": "614-717-0822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAESSLE",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-22",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34009785",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101017440",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "34.009785",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "OH",
            "license": "34.009785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.