MRS. TIA DOMINIQUE AGBORUCHE – Certified Registered Nurse Anesthetist, NPI 1013687029

MRS. TIA DOMINIQUE AGBORUCHE is a healthcare provider. based in Columbus, Ohio. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. 4704311021 (MI). The NPI Number for MRS. TIA DOMINIQUE AGBORUCHE is 1013687029

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
MRS. TIA DOMINIQUE AGBORUCHE
NPI
1013687029
Phone
(614) 293-8487
Address
410 W 10th Ave Fl 1
Enumeration Date
20 September 2021
Last Update Date
7 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5179756000
Graduation Year
2021 (5 years ago)
PAC ID
5799170007
Group Practice PAC ID
8628975968
Professional Enrollment ID
I20220324000403
Address ID
MI489108394LA2900XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:4State licenses:2Digital endpointsOther names

3,016 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in OH

Provider Addresses for MRS. TIA DOMINIQUE AGBORUCHE

  • 410 W 10th Ave Fl 1

    Columbus, OH 432101240

    Phone: (614) 293-8487

    Fax: (614) 293-8153

    Type: Location

  • 20418 BINDER ST

    DETROIT, MI 482341913

    Phone: (313) 333-4038

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $16.

Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.

Last reported payment date: 2023-07-17 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($16).

Total Amount

$16

General + Research + Ownership

Payments

1

Total payment records

General Amount

$16

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-07-17

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Merck Sharp & Dohme LLC$16
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-11-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220324000403ICertified Registered Nurse Anesthetist (Crna)MITBD
I20241108001928ICertified Registered Nurse Anesthetist (Crna)OHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope1111$0
View full utilization report →

Insurance plans in this area (ZIP 43210)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8628975968View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
A N E S T H E S I O L O G YMI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
A N E S T H E S I O L O G YMI
Certified Registered Nurse Anesthetist (Crna)MI
A N E S T H E S I O L O G YMI
Certified Registered Nurse Anesthetist (Crna)MI

Reviews

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Frequently asked questions

What NPI should I save for MRS. TIA DOMINIQUE AGBORUCHE?
Save NPI 1013687029 if you need a stable reference for MRS. TIA DOMINIQUE AGBORUCHE.
Is MRS. TIA DOMINIQUE AGBORUCHE's NPI currently valid?
The extract we use shows MRS. TIA DOMINIQUE AGBORUCHE as active.
Does MRS. TIA DOMINIQUE AGBORUCHE list a primary specialty?
If you are matching referrals, note Certified Registered Nurse Anesthetist for MRS. TIA DOMINIQUE AGBORUCHE. Clinical services aligned with this taxonomy classification.
What location shows for MRS. TIA DOMINIQUE AGBORUCHE?
We surface Columbus, Ohio for MRS. TIA DOMINIQUE AGBORUCHE based on available NPPES addresses.
Is MRS. TIA DOMINIQUE AGBORUCHE a real provider?
This page reflects official NPPES data for NPI 1013687029. Always confirm identity and privileges with the practice and licensing boards.

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