Individual provider Active NPI

Carlos Canek Cordero-Caballero, MD, MS

  • General Practice Physician
  • Columbus, OH
National Provider Identifier
1730640871
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
35.152806 Issued in OH
Practice address
5100 Karl Rd
Columbus, OH 43229-5141
Phone
(614) 262-5094
NPI assigned
Mar 29, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 35.152806 OH Primary

Addresses

Primary practice location

5100 Karl Rd
Columbus, OH 43229-5141

Mailing address

395 W 12TH Ave RM 662
Columbus, OH 43210-1267
Phone (614) 293-8000

Other practice location 1

395 W 12th Ave Rm 662
Columbus, OH 43210-1267
Phone (614) 293-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308

3601 SW 160TH Ave
Suite 250
Miramar, FL 95439

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.152806OHMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1730640871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 W 12TH AVE RM 662",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101267",
            "telephone_number": "614-293-8000",
            "fax_number": "614-293-4063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 KARL RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432295141",
            "telephone_number": "614-262-5094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "395 W 12th Ave Rm 662",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101267",
            "country_code": "US",
            "telephone_number": "614-293-8000",
            "fax_number": "614-293-4063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORDERO-CABALLERO",
        "first_name": "CARLOS",
        "middle_name": "CANEK",
        "name_prefix": "Mr.",
        "credential": "MD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-29",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OH",
            "license": "35.152806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.