Douglas J Deprofio, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

50-001909 Issued in OH

Practice address

931 Chatham LN
Columbus, OH 43221-2417

Phone

(614) 533-5500

Fax

(614) 533-5593

NPI assigned

Sep 2, 2005

Last updated

Jan 25, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2002

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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
  Medicare reassignment Care Compare group NPD
• Ohiohealth Corporation

  dba OhioHealth Physician Group Inc

  • Anesthesiology Physician
  • Columbus, OH
  • NPI 1407292105
  NPD
• Neurological Associates, Inc

  • Neurological Surgery Physician
  • Columbus, OH
  • NPI 1386799625
  NPD (past)

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

• 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": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1871587071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 FRANTZ RD",
            "address_2": "STE 360",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430164134",
            "telephone_number": "614-544-6155",
            "fax_number": "614-544-6370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 CHATHAM LN",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432212417",
            "telephone_number": "614-533-5500",
            "fax_number": "614-533-5593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPROFIO",
        "first_name": "DOUGLAS",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-02",
        "last_updated": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50-001909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0068078",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ddeprofio32123@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "3555 Olentangy River Rd",
            "address_2": "Ste 2001",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432143912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Allison Depoy, LISW-S
• Randy Lewis Depoy, RPH
• Krisanna Lee Deppen, MD
• Brent Depriest
• Montez Depriest
• Dept of Veteran Affairs
• Anna Elisabeth Deptola, OTD, OTR/L
• Heather Irene May Depuy
• Matthew A Derby, DO
• James W. Derck, M.D.

• Surgical Physician Assistant in Columbus, OH
• Providers in Columbus, OH by specialty
• Surgical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.