Organization Active NPI

Mid-Ohio Medical Specialists, Inc.

  • Internal Medicine Physician
  • Columbus, OH
National Provider Identifier
1982818381
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35047929 Issued in OH
Legal business name
MID-OHIO MEDICAL SPECIALISTS, INC.
Practice address
949 E Livingston Ave
Columbus, OH 43205-2748
Phone
(614) 445-7209
Fax
(614) 656-7068
NPI assigned
May 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Authorized official

Name
Mrs. Nayyar Fatima Shareef, MD
Title
Vice-President
Phone
(614) 445-7209

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 35067934 OH
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 35047929 OH Primary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X 35047929 OH
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X 35047929 OH

Addresses

Primary practice location

949 E Livingston Ave
Columbus, OH 43205-2748

Mailing address

949 E Livingston Ave
Columbus, OH 43205-2748
Phone (614) 445-7209

Other identifiers 2

IdentifierTypeStateIssuer
0170550MedicaidOH
0764098MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080624000747 OH Part B Supplier - Clinic/Group Practice 5294806998 Receives reassigned benefits from 1 practitioner
Practice locations: Bellefontaine, OH; Colubus, OH; Columbus, OH; Westerville, OH

National Provider Directory

National Provider Directory

Locations

36 Lehman Dr
Ste 1006
Canal Wnchstr, OH 43110

147 Lewis Ave 4
Circleville, OH 43113
Phone (740) 477-1090

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734393600000",
    "number": "1982818381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "949 E LIVINGSTON AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052748",
            "telephone_number": "614-445-7209",
            "fax_number": "937-599-7035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 E LIVINGSTON AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052748",
            "telephone_number": "614-445-7209",
            "fax_number": "614-656-7068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-OHIO MEDICAL SPECIALISTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A",
        "authorized_official_last_name": "SHAREEF",
        "authorized_official_first_name": "NAYYAR",
        "authorized_official_middle_name": "FATIMA",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "614-445-7209",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35067934",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35047929",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OH",
            "license": "35047929",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OH",
            "license": "35047929",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0170550",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0764098",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.