Individual provider Active NPI

Tony Paul Pathadan, DO

  • Internal Medicine Physician
  • Kirksville, MO
National Provider Identifier
1720566862
Registry record updated Jul 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2018023113 Issued in MO
Practice address
315 S Osteopathy Ave
Kirksville, MO 63501-6401
Phone
(660) 785-1000
NPI assigned
Jul 31, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2018023113 MO Primary

Addresses

Primary practice location

315 S Osteopathy Ave
Kirksville, MO 63501-6401

Mailing address

715 Erin PL
Kirksville, MO 63501-4698

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
I20210907001675 OH Practitioner - Internal Medicine 3476959032 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Pikeville, Kentucky College of Osteopathic Med, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Ohio Hospitalists, IncGroup PAC ID 7810985686, 194 clinicians

Practice addresses (Care Compare)

3525 Olentangy River Rd
Suite 4330
Columbus, OH 43214-3937
Phone 61425569001122

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2018023113MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Medical Group, LLC CurrentSince Mar 7, 2022 Accepting new patients
Central Ohio Hospitalists, Inc CurrentSince Aug 30, 2021 Accepting new patients
Genesis Medical Group LLC Internal Medicine CurrentSince Mar 7, 2022 Accepting new patients
Genesis Healthcare System Past Accepting new patients
Ohiohealth Corporation Past Accepting new patients

Locations

3535 Olentangy River Rd
Columbus, OH 43214
Phone (614) 566-1997

3525 Olentangy River Rd
Ste 4330
Columbus, OH 43214
Phone (614) 255-6930

401 Matthew St
Marietta, OH 45750
Phone (740) 374-1400

945 Bethesda Dr
Ste 330
Zanesville, OH 43701
Phone (740) 454-4038

2951 Maple Ave
Zanesville, OH 43701
Phone (740) 454-4000

Organizations & group practices 6

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 8

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": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1720566862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 ERIN PL",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S OSTEOPATHY AVE",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635016401",
            "telephone_number": "660-785-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATHADAN",
        "first_name": "TONY",
        "middle_name": "PAUL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-31",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2018023113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirksville, MO

Sources for this page

Verify at the official NPI Registry.