Individual provider Active NPI

Tyler M Angelos, MD

  • Plastic Surgery Physician
  • Upper Arlington, OH
National Provider Identifier
1730317264
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
35.125866 Issued in OH
Practice address
5005 Arlington Centre Blvd
Upper Arlington, OH 43220-2912
Phone
(614) 246-6900
NPI assigned
Jun 23, 2009
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 35.125866 OH Primary

Addresses

Primary practice location

5005 Arlington Centre Blvd
Upper Arlington, OH 43220-2912

Mailing address

5005 Arlington Centre Blvd
Upper Arlington, OH 43220-2912
Phone (614) 246-6900

Other practice location 1

4030 Easton Sta Ste 260
Columbus, OH 43219-7012
Phone (614) 246-6900

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
I20150619001587 OH Practitioner - Plastic and Reconstructive Surgery 0749424638 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.125866OHMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Aesthetic and Plastic Surgery, Inc Plastic Surgery CurrentSince Jul 13, 2015 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

4030 Easton Sta
Ste 260
Columbus, OH 43219
Phone (614) 246-6900

1356 Cherry Way Dr
Gahanna, OH 43230
Phone 6142466900 ext. 66900

4971 Arlington Centre Blvd
Upper Arlngtn, OH 43220
Phone (614) 246-6900

5005 Arlington Centre Blvd
Upper Arlngtn, OH 43220
Phone (614) 246-6900

Organizations & group practices 2

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": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1730317264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 ARLINGTON CENTRE BLVD",
            "city": "UPPER ARLINGTON",
            "state": "OH",
            "postal_code": "432202912",
            "telephone_number": "614-246-6900",
            "fax_number": "614-246-6909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 ARLINGTON CENTRE BLVD",
            "city": "UPPER ARLINGTON",
            "state": "OH",
            "postal_code": "432202912",
            "telephone_number": "614-246-6900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4030 Easton Sta Ste 260",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432197012",
            "country_code": "US",
            "telephone_number": "614-246-6900",
            "fax_number": "614-246-6909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANGELOS",
        "first_name": "TYLER",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "OH",
            "license": "35.125866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Arlington, OH

Sources for this page

Verify at the official NPI Registry.