Active NPI
Martina Blazevic
- Dermatology Physician
- Columbus, OH
National Provider Identifier
1801653373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 57.258346
- Practice address
- 3595 Olentangy River Rd
Columbus, OH 43214-3440 - Phone
- (614) 566-5456
- NPI assigned
- Mar 1, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 57.258346 | OH | Primary |
Addresses
Primary practice location
3595 Olentangy River Rd
Columbus, OH 43214-3440
Mailing address
18501 Hilliard Blvd Apt 110
Rocky River, OH 44116-2934
Phone (440) 454-5469
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250723003289 | OH | Order and Referring Only - Dermatology | 3072029255 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1709251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784073600000",
"number": "1801653373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18501 HILLIARD BLVD APT 110",
"city": "ROCKY RIVER",
"state": "OH",
"postal_code": "441162934",
"telephone_number": "440-454-5469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3595 OLENTANGY RIVER RD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432143440",
"telephone_number": "614-566-5456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAZEVIC",
"first_name": "MARTINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-01",
"last_updated": "2026-07-15",
"certification_date": "2026-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "OH",
"license": "57.258346",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.