NPIMap

Organization Active NPI

Central Ohio Skin & Cancer Inc

  • Dermatology Physician
  • Westerville, OH
National Provider Identifier
1922016864
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
CENTRAL OHIO SKIN & CANCER INC
Practice address
430 Altair Pkwy
Ste 210
Westerville, OH 43082-7647
Phone
(614) 898-7546
Fax
(614) 794-4294
NPI assigned
Aug 4, 2006
Last updated
Feb 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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

Authorized official

Name
Jess J Demaria, M.D.NPI 1154373009
Title
Owner Physicican
Phone
(614) 898-7546

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

430 Altair Pkwy
Ste 210
Westerville, OH 43082-7647

Mailing address

430 Altair Pkwy
Ste 210
Westerville, OH 43082-7647
Phone (614) 898-7546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050927000501 OH Part B Supplier - Clinic/Group Practice 4688608870 Receives reassigned benefits from 14 practitioners
4 other NPIs on this enrollment
Practice locations: Powell, OH; Westerville, OH

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0701078Central Ohio Skin & Cancer, Inc430 Altair Parkway, Suite 210, Westerville, OH 43082ComplianceDec 20, 2027

National Provider Directory

National Provider Directory

Locations

10212 Sawmill Pkwy
Powell, OH 43065
Phone (614) 898-7546

300 Polaris Pkwy
Ste 3300
Westerville, OH 43082
Phone (614) 898-7546

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708646400000",
    "number": "1922016864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 ALTAIR PKWY",
            "address_2": "STE 210",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430827647",
            "telephone_number": "614-898-7546",
            "fax_number": "614-794-4294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 ALTAIR PKWY",
            "address_2": "STE 210",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430827647",
            "telephone_number": "614-898-7546",
            "fax_number": "614-794-4294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL OHIO SKIN & CANCER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2024-02-23",
        "status": "A",
        "authorized_official_last_name": "DEMARIA",
        "authorized_official_first_name": "JESS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER PHYSICICAN",
        "authorized_official_telephone_number": "614-898-7546",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.