Individual provider Active NPI

Christopher Sean Ambrosino, CNP

  • Adult Health Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1720395239
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
COA.11730-NP Issued in OH
Practice address
111 S Grant Ave
Columbus, OH 43215-4701
Phone
(614) 566-9160
Fax
(614) 566-8392
NPI assigned
Sep 3, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X COA.11730-NP OH Primary

Addresses

Primary practice location

111 S Grant Ave
Columbus, OH 43215-4701

Mailing address

5450 Frantz Rd Ste 360
Dublin, OH 43016-4141

Other identifiers 1

IdentifierTypeStateIssuer
3103199MedicaidOH

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
I20101209001203 OH Practitioner - Nurse Practitioner 3375730898 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland Surgical Associates, Inc.Group PAC ID 3577566371, 26 clinicians
Encore Clinical Services LLCGroup PAC ID 5991177313, 49 clinicians

Practice addresses (Care Compare)

12301 Ridge Rd
North Royalton, OH 44133-3744
Phone (440) 652-8748

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA.11730-NPOHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Oct 4, 2010 Accepting new patients
Cleveland Surgical Associates, Inc. CurrentSince Jul 15, 2023 Accepting new patients
Lake Effect Health Current Accepting new patients
Encore Clinical Services LLC Adult Health CurrentSince Nov 11, 2024 Accepting new patients
Ohiohealth Corporation CurrentSince Oct 4, 2010 Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

111 S Grant Ave
Columbus, OH 43215
Phone (614) 461-3232

Dept L3652
Columbus, OH 43260

5400 Frantz Rd
Ste 250
Dublin, OH 43016
Phone (614) 544-6161

5450 Frantz Rd
Ste 360
Dublin, OH 43016
Phone (614) 533-6497

335 Glessner Ave
Mansfield, OH 44903
Phone (419) 522-0320

12301 Ridge Rd
North Royalton, OH 44133
Phone (216) 331-6750

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": "1283472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1720395239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 FRANTZ RD STE 360",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430164141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S GRANT AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432154701",
            "telephone_number": "614-566-9160",
            "fax_number": "614-566-8392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROSINO",
        "first_name": "CHRISTOPHER",
        "middle_name": "SEAN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-03",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "COA.11730-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3103199",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.