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Individual provider Active NPI

Jennifer Dean Niewiadomski, PA-C

  • Surgical Physician Assistant
  • Columbus, OH
National Provider Identifier
1639549108
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
50.004437 Issued in OH
Practice address
1313 Olentangy River Rd
Columbus, OH 43212-3120
Phone
(614) 890-6555
Fax
(614) 823-8881
NPI assigned
Sep 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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 50.004437 OH Primary

Addresses

Primary practice location

1313 Olentangy River Rd
Columbus, OH 43212-3120

Mailing address

6480 Harrison Ave Ste 201
Cincinnati, OH 45247-7961
Phone (513) 795-4049

Other identifiers 2

IdentifierTypeStateIssuer
0145495MedicaidOH
H465660OtherOHMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151103001280 OH Practitioner - Physician Assistant 5890005870 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6480 Harrison Ave
Cincinnati, OH 45247-7821
Phone (513) 354-3700

6480 Harrison Ave
Suite 201
Cincinnati, OH 45247-7961

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Orthopaedics & Sports Medicine, LTD CurrentSince Nov 22, 2022 Accepting new patients
Beacon Orthopaedics & Sports Medicine LTD CurrentSince Nov 22, 2022 Accepting new patients
Orthopedic & Neurological Consultants, Inc CurrentSince Sep 28, 2015 Accepting new patients
Orthopedic & Neurological Consultants, Inc. Surgical CurrentSince Sep 28, 2015 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

6480 Harrison Ave
Cincinnati, OH 45247
Phone (513) 251-7827

6480 Harrison Ave
Ste 201
Cincinnati, OH 45247
Phone (513) 354-7650

L 3973
Columbus, OH 43260

1313 Olentangy River Rd
Columbus, OH 43212
Phone (614) 221-3725

5040 Forest Dr
New Albany, OH 43054
Phone (614) 546-4300

5040 Forest Dr
Ste 300
New Albany, OH 43054
Phone (614) 839-2128

1030 Refugee Rd
Ste 180
Pickerington, OH 43147

70 S Cleveland Ave
Westerville, OH 43081
Phone (614) 839-2115

Interoperability endpoints

  • Direct secure messaging: jennifer.dean.p1@direct.beaconortho.nextgenshare.com

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 9

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": "1443398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1639549108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6480 HARRISON AVE STE 201",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452477961",
            "telephone_number": "513-795-4049",
            "fax_number": "513-354-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 OLENTANGY RIVER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432123120",
            "telephone_number": "614-890-6555",
            "fax_number": "614-823-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEWIADOMSKI",
        "first_name": "JENNIFER",
        "middle_name": "DEAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-28",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50.004437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0145495",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "H465660",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.