Individual provider Active NPI

Cynthia Ann Koutz, MS, PA-C

  • Physician Assistant
  • Columbus, OH
National Provider Identifier
1699786145
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.002703 Issued in OH
Practice address
915 Olentangy River Rd Ste 2140
Columbus, OH 43212-3153
Phone
(614) 293-8566
Fax
(614) 293-3381
NPI assigned
Aug 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.002703 OH Primary

Addresses

Primary practice location

915 Olentangy River Rd Ste 2140
Columbus, OH 43212-3153

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-8566

Other identifiers 1

IdentifierTypeStateIssuer
0081956MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ckoutz5322@direct.osumc.edu

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
I20080124000339 OH Practitioner - Physician Assistant 5890877229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osu Plastic Surgery LLCGroup PAC ID 2961677679, 43 clinicians

Practice addresses (Care Compare)

1145 Olentangy River Rd
Columbus, OH 43212-3117
Phone (614) 293-0223

915 Olentangy River Rd
Columbus, OH 43212-3153
Phone (614) 293-8566

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.002703OHMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: ckoutz5322@direct.osumc.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1699786145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-8566",
            "fax_number": "614-293-3381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 OLENTANGY RIVER RD STE 2140",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432123153",
            "telephone_number": "614-293-8566",
            "fax_number": "614-293-3381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUTZ",
        "first_name": "CYNTHIA",
        "middle_name": "ANN",
        "credential": "MS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.002703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0081956",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ckoutz5322@direct.osumc.edu",
            "affiliation": "N",
            "address_1": "915 Olentangy River Rd Ste 2140",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432123153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.