Melinda Kristine Jack, M.D.

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

35-088654 Issued in OH

Practice address

5965 E Broad St
Suite 120
Columbus, OH 43213-1562

Phone

(614) 864-1000

Fax

(614) 864-1444

NPI assigned

Dec 12, 2006

Last updated

Jan 5, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

General SurgeryAlso: Colorectal Surgery (Proctology)

Education

University of Cincinnati College of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006
• Grant Medical Center Hospital, Columbus, OH, CCN 360017

Merit-based Incentive Payment System (MIPS)

Final score

80.04 of 100Reported as group

Quality

58.67

Promoting interoperability

98

Improvement activities

40

Cost

76.46

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mjack13509@direct.ohiohealth.com

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.

• Ohiohealth Corporation

  dba OhioHealth Physician Group, Inc

  • Family Medicine Physician
  • Columbus, OH
  • NPI 1578545273

  Colon & Rectal Surgery

  Medicare reassignment Care Compare group NPD
• Ohiohealth Corporation

  dba OhioHealth Physician Group Inc

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Columbus, OH
  • NPI 1265627301
  NPD
• Ohiohealth Corporation

  dba OhioHealth Physician Group Inc

  • Anesthesiology Physician
  • Columbus, OH
  • NPI 1407292105
  NPD
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Ohiohealth Corporation

  dba Riverside Methodist Hospital

  • General Acute Care Hospital
  • Columbus, OH
  • NPI 1467484972
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ohiohealth Corporation

  dba Grant Medical Center

  • General Acute Care Hospital
  • Columbus, OH
  • NPI 1255377149
  Care Compare affiliation
• Ohiohealth Corporation

  dba Riverside Methodist Hospital

  • General Acute Care Hospital
  • Columbus, OH
  • NPI 1467484972
  Care Compare affiliation
• Ohiohealth Corporation

  dba OhioHealth Laboratory Systems

  • Clinical Medical Laboratory
  • Columbus, OH
  • NPI 1710916945

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1760543177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5965 E BROAD ST",
            "address_2": "SUITE 120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432131562",
            "telephone_number": "614-864-1000",
            "fax_number": "614-864-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5965 E BROAD ST",
            "address_2": "SUITE 120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432131562",
            "telephone_number": "614-864-1000",
            "fax_number": "614-864-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACK",
        "first_name": "MELINDA",
        "middle_name": "KRISTINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35088654",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "OH",
            "license": "35-088654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjack13509@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "500 Thomas Ln",
            "address_2": "Ste 4A",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432143902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jacinto W. Beard D.D.S., Inc.
• Jack Stanko MD LLC
• Jack Stoneburner & Associates LLC
• Andrew Jack
• Haejin Jack, APRN-CNP
• Karen Achie Jackman, D.C.
• Joseph G Jacko, MD
• Hannah Jackowski, RD
• Michael J Jackowski
• Amy Elizabeth Jacks, MD

• Colon & Rectal Surgery Physician in Columbus, OH
• Providers in Columbus, OH by specialty
• Colon & Rectal Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.