Individual provider Active NPI

Jeffrey Robert Hawley, MD

  • Diagnostic Radiology Physician
  • Columbus, OH
National Provider Identifier
1659592004
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
35.090152 Issued in OH
Practice address
395 W 12TH Ave
Room 460
Columbus, OH 43210-1267
Phone
(614) 293-8369
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 35.090152 OH Primary

Addresses

Primary practice location

395 W 12TH Ave
Room 460
Columbus, OH 43210-1267

Mailing address

395 W 12TH Ave
Room 460
Columbus, OH 43210-1267

Other identifiers 2

IdentifierTypeStateIssuer
3810017116MedicaidWV
3034255MedicaidOH

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
I20100909000097 OH Practitioner - Diagnostic Radiology 9638294077 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Ohio State University College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifecare AllianceGroup PAC ID 3274558713, 13 clinicians
Osu Radiology LLCGroup PAC ID 8921031675, 180 clinicians

Practice addresses (Care Compare)

1699 W Mound St
Columbus, OH 43223-1809
Phone (614) 437-2876

395 W 12TH Ave
RM 460
Columbus, OH 43210-1267
Phone (614) 293-8315

Hospital & facility affiliations

  • James Cancer Hospital & Solove Research Institute Hospital, Columbus, OH, CCN 360242
  • Ohio State University State Health System Hospital, Columbus, OH, CCN 360085

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.090152OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifecare Alliance Diagnostic Radiology CurrentSince Feb 6, 2024 Accepting new patients
Osu Radiology LLC Diagnostic Radiology CurrentSince Jul 1, 2010 Accepting new patients
Lifecare Alliance CurrentSince Feb 6, 2024 Accepting new patients

Locations

1699 W Mound St
Columbus, OH 43223
Phone (614) 278-3130

395 W 12th Ave
Rm 460
Columbus, OH 43210
Phone (614) 293-8299

700 Ackerman Rd
Ste 570
Columbus, OH 43202
Phone (614) 293-2046

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 3

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 4

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": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279756800000",
    "number": "1659592004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 W 12TH AVE",
            "address_2": "ROOM 460",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 W 12TH AVE",
            "address_2": "ROOM 460",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101267",
            "telephone_number": "614-293-8369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWLEY",
        "first_name": "JEFFREY",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2010-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35.090152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810017116",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3034255",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.