Organization Active NPI

Columbus Institute of Plastic Surgery LTD

  • Plastic Surgery Physician
  • Columbus, OH
National Provider Identifier
1720179674
Registry record updated Feb 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
COLUMBUS INSTITUTE OF PLASTIC SURGERY LTD
Practice address
6499 E Broad St
Suite 130
Columbus, OH 43213-6505
Phone
(614) 235-2326
Fax
(614) 235-5194
NPI assigned
Sep 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2013

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

Authorized official

Name
Bivik Shah, MDNPI 1558367839
Title
President
Phone
(614) 235-2326

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

6499 E Broad St
Suite 130
Columbus, OH 43213-6505

Mailing address

6499 E Broad St
Suite 130
Columbus, OH 43213-6505
Phone (614) 322-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040715001232 OH Part B Supplier - Clinic/Group Practice 0446239297 Receives reassigned benefits from 3 practitioners
Practice locations: Columbus, OH; Dublin, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D1042156Columbus Institute of Plastic Surgery6499 East Broad Street Suite 130, Columbus, OH 43213Certificate of waiverJun 20, 2027

National Provider Directory

National Provider Directory

Locations

6750 Perimeter Dr
Dublin, OH 43016
Phone (614) 482-2123

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360022400000",
    "number": "1720179674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6499 E BROAD ST",
            "address_2": "SUITE 130",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432136505",
            "telephone_number": "614-322-2500",
            "fax_number": "614-322-2532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6499 E BROAD ST",
            "address_2": "SUITE 130",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432136505",
            "telephone_number": "614-235-2326",
            "fax_number": "614-235-5194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBUS INSTITUTE OF PLASTIC SURGERY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2013-02-05",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "BIVIK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "614-235-2326",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.