Individual provider Active NPI

Michael Joseph Snedeker, PA-C

  • Physician Assistant
  • Granville, OH
National Provider Identifier
1780954206
Registry record updated Jan 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
003416 Issued in OH
Practice address
2000 Newark Granville Rd
202
Granville, OH 43023-7009
Phone
(740) 587-3376
NPI assigned
Jan 2, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 003416 OH Primary

Addresses

Primary practice location

2000 Newark Granville Rd
202
Granville, OH 43023-7009

Mailing address

7213 Bolton Priory Dr
New Albany, OH 43054-4011

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
I20120314000571 OH Practitioner - Physician Assistant 6608035480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Surgical Dermatology IncGroup PAC ID 9739087602, 33 clinicians

Practice addresses (Care Compare)

1566 Monmouth Dr
Suite 201
Lancaster, OH 43130-8048
Phone (740) 687-1177

428 County Line Rd W
Westerville, OH 43082-7027
Phone (614) 847-4100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.85 of 100Reported as group
Promoting interoperability
81
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
003416OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
CSD ASC LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: msnedeker@directaddress.net

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1325462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325462400000",
    "number": "1780954206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7213 BOLTON PRIORY DR",
            "city": "NEW ALBANY",
            "state": "OH",
            "postal_code": "430544011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 NEWARK GRANVILLE RD",
            "address_2": "202",
            "city": "GRANVILLE",
            "state": "OH",
            "postal_code": "430237009",
            "telephone_number": "740-587-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNEDEKER",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-02",
        "last_updated": "2012-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "003416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granville, OH

Sources for this page

Verify at the official NPI Registry.