Provider Demographics
NPI:1518972900
Name:COLUMBUS PODIATRY & SURGERY, INC.
Entity Type:Organization
Organization Name:COLUMBUS PODIATRY & SURGERY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANIMESH
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATIA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:614-323-6366
Mailing Address - Street 1:117 LAZELLE RD E.
Mailing Address - Street 2:#B
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-8605
Mailing Address - Country:US
Mailing Address - Phone:614-885-3338
Mailing Address - Fax:877-877-4797
Practice Address - Street 1:117 LAZELLE RD E.
Practice Address - Street 2:#B
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-8605
Practice Address - Country:US
Practice Address - Phone:614-885-3338
Practice Address - Fax:877-877-4797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35061998207Q00000X
OH36003042213ES0103X
OH36003547213ES0103X
OH50001647363AM0700X
OHCOA07955NP363L00000X
OH10669NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2797326Medicaid
DG4668OtherRAILROAD MEDICARE
DG4668OtherRAILROAD MEDICARE
OH3997690002Medicare NSC