Individual provider Active NPI

Patrick S Callender, DO

  • Internal Medicine Physician
  • Columbus, OH
National Provider Identifier
1922006675
Registry record updated Aug 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
3400-7319C Issued in OH
Practice address
104 N Murray Hill Rd
Columbus, OH 43228-1524
Phone
(614) 878-6413
Fax
(614) 878-1159
NPI assigned
Jul 7, 2005
Last updated
Aug 6, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 3400-7319C OH Primary

Addresses

Primary practice location

104 N Murray Hill Rd
Columbus, OH 43228-1524

Mailing address

104 N Murray Hill Rd
Columbus, OH 43228-1524
Phone (614) 878-6413

Other identifiers 1

IdentifierTypeStateIssuer
2161655MedicaidOH

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200422001023 OH Practitioner - Internal Medicine 1153652201 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
3400-7319COHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Columbus Ohio, LLC Internal Medicine CurrentSince Apr 16, 2020 Accepting new patients
Dedicated Columbus Ohio, LLC CurrentSince Apr 16, 2020 Accepting new patients
Imagyn Medical Associates, LTD Internal Medicine Past Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

2260 Morse Rd
Columbus, OH 43229
Phone (305) 831-4453

5156 E Main St
Columbus, OH 43213
Phone (614) 702-7655

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375747200000",
    "number": "1922006675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 N MURRAY HILL RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432281524",
            "telephone_number": "614-878-6413",
            "fax_number": "614-878-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 N MURRAY HILL RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432281524",
            "telephone_number": "614-878-6413",
            "fax_number": "614-878-1159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLENDER",
        "first_name": "PATRICK",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2013-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "3400-7319C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2161655",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.