Individual provider Active NPI

Kathryn Elizabeth Mora, PA-C

  • Surgical Physician Assistant
  • Columbus, OH
National Provider Identifier
1881165215
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
50.005736RX Issued in OH
Practice address
915 Olentangy River Rd Ste 3200
Columbus, OH 43212-3167
Phone
(614) 293-2663
Fax
(614) 293-2053
NPI assigned
Dec 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 50.005736RX OH Primary

Addresses

Primary practice location

915 Olentangy River Rd Ste 3200
Columbus, OH 43212-3167

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-2663

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
I20190117001528 OH Practitioner - Physician Assistant 1254677958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osu Internal Medicine LLCGroup PAC ID 5496651408, 1,141 clinicians

Practice addresses (Care Compare)

2835 Fred Taylor Dr
Columbus, OH 43202-1552
Phone (614) 293-2663

3900 Stoneridge LN
Dublin, OH 43017-2288
Phone (614) 366-5001

410 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-8000

450 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-8000

452 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-8000

460 W 10TH Ave
Columbus, OH 43210-1240
Phone (800) 293-5066

6100 N Hamilton Rd
Westerville, OH 43081-2062
Phone (614) 814-8100

915 Olentangy River Rd
Columbus, OH 43212-3153
Phone (614) 293-2663

Hospital & facility affiliations

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: kbezbatchenko914950@direct.osumc.edu

Organizations & group practices 1

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 3

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": "1544486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1881165215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-2663",
            "fax_number": "614-293-2053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 OLENTANGY RIVER RD STE 3200",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432123167",
            "telephone_number": "614-293-2663",
            "fax_number": "614-293-2053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORA",
        "first_name": "KATHRYN",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-11",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50.005736RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.