Individual provider Active NPI

Andrew Donn Conkle, PA

  • Surgical Physician Assistant
  • Columbus, OH
National Provider Identifier
1639132129
Registry record updated Apr 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
50.001081 Issued in OH
Practice address
285 E State St
Suite 400
Columbus, OH 43215-4354
Phone
(614) 566-7370
NPI assigned
Apr 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 50.001081 OH Primary

Addresses

Primary practice location

285 E State St
Suite 400
Columbus, OH 43215-4354

Mailing address

5400 Frantz Rd
Suite 250
Dublin, OH 43016-4144
Phone (614) 544-6356

Other identifiers 1

IdentifierTypeStateIssuer
0094443MedicaidOH

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
I20131206001391 OH Practitioner - Physician Assistant 8325275811 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

111 S Grant Ave
Columbus, OH 43215-4701

111 S Grant Ave 3Rd FL
Columbus, OH 43215-4701
Phone (614) 566-9184

393 E Town St
Columbus, OH 43215-4799

Hospital & facility affiliations

  • Grant Medical Center Hospital, Columbus, OH, CCN 360017
  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1081OHMDChiropractor
50.001081OHMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Aug 31, 2015 Accepting new patients
Ohiohealth Corporation CurrentSince Aug 31, 2015 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

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

85 McNaughten Rd
Ste 110
Columbus, OH 43213
Phone (614) 751-8846

Dept L3652
Columbus, OH 43260

285 E State St
Ste 400
Columbus, OH 43215
Phone (614) 566-7370

5400 Frantz Rd
Ste 250
Dublin, OH 43016
Phone (614) 544-6161

Organizations & group practices 5

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 3

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": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1639132129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 FRANTZ RD",
            "address_2": "SUITE 250",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430164144",
            "telephone_number": "614-544-6356",
            "fax_number": "614-544-6370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 E STATE ST",
            "address_2": "SUITE 400",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432154354",
            "telephone_number": "614-566-7370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLE",
        "first_name": "ANDREW",
        "middle_name": "DONN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50.001081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0094443",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.