Individual provider Active NPI

Marissa C Dejesus, APRN-CNP

  • Family Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1912989583
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.08566 Issued in OH
Practice address
300 W 10TH Ave FL 1
Columbus, OH 43210-1280
Phone
(614) 293-8714
Fax
(614) 293-4281
NPI assigned
Nov 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.08566 OH Primary

Addresses

Primary practice location

300 W 10TH Ave FL 1
Columbus, OH 43210-1280

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-8714

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
I20051222000006 OH Practitioner - Nurse Practitioner 9234151937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
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)

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

Hospital & facility affiliations

  • Ohio State University State Health System Hospital, Columbus, OH, CCN 360085
  • James Cancer Hospital & Solove Research Institute Hospital, Columbus, OH, CCN 360242
  • Mary Rutan Hospital Hospital, Bellefontaine, OH, CCN 360197

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Osu Internal Medicine, LLC CurrentSince Jul 1, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

300 W 10th Ave
Fl 1
Columbus, OH 43210
Phone (614) 293-5066

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

700 Ackerman Rd
Ste 570
Columbus, OH 43202
Phone (614) 293-2046

410 W 10th Ave
#N1022
Columbus, OH 43210

410 W 10th Ave
Rm N122
Columbus, OH 43210

300 W 10th Ave
Columbus, OH 43210
Phone (614) 293-3276

410 W 10th Ave
#10N
Columbus, OH 43210
Phone (614) 293-0821

1299 Olentangy River Rd
Ste 103
Columbus, OH 43212
Phone (614) 566-4278

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

680 Park Ave W
Mansfield, OH 44906
Phone (419) 522-1100

Interoperability endpoints

  • Direct secure messaging: marissa.dejesus.1@19222.direct.athenahealth.com
  • Direct secure messaging: mdejesus9556@direct.osumc.edu

Organizations & group practices 3

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 5

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": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1912989583",
    "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": "614-293-8714",
            "fax_number": "614-293-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W 10TH AVE FL 1",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101280",
            "telephone_number": "614-293-8714",
            "fax_number": "614-293-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJESUS",
        "first_name": "MARISSA",
        "middle_name": "C",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.08566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.