Individual provider Active NPI

Amanda Rae Jensen, MD

  • Pediatric Surgery Physician
  • Columbus, OH
National Provider Identifier
1649619941
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
35.139714 Issued in OH
Practice address
700 Childrens Dr
Columbus, OH 43205-2664
Phone
(614) 722-2000
NPI assigned
Jun 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X 35.139714 OH Primary
Transplant Surgery Physician 204F00000X 35.139714 OH

Addresses

Primary practice location

700 Childrens Dr
Columbus, OH 43205-2664

Mailing address

700 Childrens Dr
Columbus, OH 43205-2664
Phone (614) 722-2000

Other practice location 1

455 Executive Campus Dr
Westerville, OH 43082-8870
Phone (614) 722-2000

Other practice location 2

405 Butterfly Gardens Dr # Na
Columbus, OH 43215-4985
Phone (614) 722-2000

Other identifiers 1

IdentifierTypeStateIssuer
0118840MedicaidOH

Other names 1

  • Amanda Rae Dorale Former name

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
I20250819002667 OH Practitioner - General SurgeryPractitioner - Pediatric Medicine 3779725767 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Pediatric Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Children'S Surgical Associates, CorporationGroup PAC ID 1254328511, 49 clinicians

Practice addresses (Care Compare)

700 Children'S Dr
Columbus, OH 43205-2664
Phone (614) 722-2000

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
87.08
Promoting interoperability
100
Improvement activities
40
Cost
69.51

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Surgical Associates, Corporation Pediatric Surgery CurrentSince Aug 1, 2025 Accepting new patients
Nationwide Children'S Hospital CurrentSince Aug 1, 2025 Accepting new patients
Nationwide Children'S Hospital CurrentSince Aug 1, 2025 Accepting new patients
Nationwide Children'S Hospital Past Accepting new patients
Nationwide Children'S Hospital Past Accepting new patients

Locations

Dept 781629
Detroit, MI 48278

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

405 Butterfly Gardens Dr
Columbus, OH 43215
Phone (614) 722-4200

555 S 18th St
Columbus, OH 43205
Phone (614) 722-4554

1 Childrens Plz
Dayton, OH 45404
Phone (937) 641-3600

455 Executive Campus Dr
Westerville, OH 43082
Phone (614) 355-6100

Interoperability endpoints

  • Direct secure messaging: ajensen4@direct.iuhealth.org

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1649619941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 Executive Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430828870",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 Butterfly Gardens Dr # Na",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432154985",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "AMANDA",
        "middle_name": "RAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-19",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "OH",
            "license": "35.139714",
            "primary": true
        },
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "OH",
            "license": "35.139714",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0118840",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "DORALE",
            "middle_name": "RAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.