Individual provider Active NPI

Jason Pedrick, M.D.

  • Family Medicine Physician
  • Dublin, OH
National Provider Identifier
1962767855
Registry record updated Oct 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-127818 Issued in OH
Practice address
6905 Hospital Dr
Suite 130
Dublin, OH 43016-9600
Phone
(614) 923-0300
NPI assigned
Jul 7, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35-127818 OH Primary

Addresses

Primary practice location

6905 Hospital Dr
Suite 130
Dublin, OH 43016-9600

Mailing address

335 Glessner Ave
Mansfield, OH 44903-2269
Phone (419) 520-2495

Other identifiers 1

IdentifierTypeStateIssuer
0122505MedicaidOH

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
I20161004002724 OH Practitioner - Family Practice 4587893938 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Northeastern Ohio University College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Ohio Primary Care Physicians, Inc.Group PAC ID 2769383785, 487 clinicians

Practice addresses (Care Compare)

695 W Central Ave
Suite C
Delaware, OH 43015-1409
Phone (740) 362-8686

Hospital & facility affiliations

  • Grady Memorial Hospital Hospital, Delaware, OH, CCN 360210

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-127818OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Urgent Care LLC CurrentSince Aug 28, 2016 Accepting new patients
Central Ohio Primary Care Physicians Inc Current Accepting new patients

Locations

Dept L3652
Columbus, OH 43260

6905 Hospital Dr
Ste 130
Dublin, OH 43016
Phone (614) 923-0300

2030 Stringtown Rd
Grove City, OH 43123
Phone (614) 566-0987

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: jpedrick18819@copcp.medicity.net

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 1

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": "1341619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1962767855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 GLESSNER AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449032269",
            "telephone_number": "419-520-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6905 HOSPITAL DR",
            "address_2": "SUITE 130",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430169600",
            "telephone_number": "614-923-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDRICK",
        "first_name": "JASON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-07",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-127818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0122505",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

Verify at the official NPI Registry.