Individual provider Active NPI

John D Baluch, MD PHD

  • Urology Physician
  • Columbus, OH
National Provider Identifier
1669441812
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
35065452B Issued in OH
Practice address
500 E Main St
Ste 220
Columbus, OH 43215
Phone
(614) 222-3369
Fax
(614) 224-1208
NPI assigned
Mar 17, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 35065452B OH Primary

Addresses

Primary practice location

500 E Main St
Ste 220
Columbus, OH 43215

Mailing address

500 E Main St
Ste 220
Columbus, OH 43215
Phone (614) 222-3369

Other identifiers 12

IdentifierTypeStateIssuer
0931657MedicaidOH
19109OtherCOLUMBUS CCOP NUMBER
315649OtherAUA PERSONAL ID NUMBER
961814OtherAETNA HMO
04112840112OtherMEDICAL ED NUMBER
3115821773A11OtherANTHEM
4330118OtherAETNA PPO
311582177001OtherCIGNA
16724OtherAM ASSOC OF CLINICAL UROL
190073OtherAM ASSOC OF CLINICAL UROL
22746OtherNCI INVESTIGATORS NUMBER
4221OtherNATIONWIDE HEALTH PLANS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35065452BOHMDUrology Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1669441812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E MAIN ST",
            "address_2": "STE 220",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43215",
            "telephone_number": "614-222-3369",
            "fax_number": "614-224-1208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E MAIN ST",
            "address_2": "STE 220",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43215",
            "telephone_number": "614-222-3369",
            "fax_number": "614-224-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALUCH",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "35065452B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0931657",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLUMBUS CCOP NUMBER",
            "identifier": "19109",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AUA PERSONAL ID NUMBER",
            "identifier": "315649",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "961814",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ED NUMBER",
            "identifier": "04112840112",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "3115821773A11",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4330118",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "311582177001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AM ASSOC OF CLINICAL UROL",
            "identifier": "16724",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AM ASSOC OF CLINICAL UROL",
            "identifier": "190073",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCI INVESTIGATORS NUMBER",
            "identifier": "22746",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONWIDE HEALTH PLANS",
            "identifier": "4221",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.