PEDIATRIC ACADEMIC ASSOCIATION, INC. – Pediatrics Physician, NPI 1063419943
Pediatrics Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for PEDIATRIC ACADEMIC ASSOCIATION, INC.
444 Butterfly Gardens Dr
Columbus, OH 432153427
Phone: (614) 722-2000
Type: Location
3535 Olentangy River Rd
Columbus, OH 432143908
Phone: (614) 566-5000
Type: Location
520 W 10th Ave
Columbus, OH 432101328
Phone: (614) 293-8000
Type: Location
7853 Pacer Dr
Delaware, OH 430157571
Phone: (614) 355-7900
Type: Location
Nationwide Children's Hospital, 700, Children's Drive, Livingston Park, Columbus, Franklin, Ohio, 43205, United States
COLUMBUS, OH 432052664
Phone: (614) 722-2000
Fax: (614) 355-4497
Type: Mailing
730 W Market St
Lima, OH 458014602
Phone: (419) 227-3361
Type: Location
401 N Ewing St
Lancaster, OH 431303372
Phone: (740) 687-6907
Type: Location
2951 Maple Ave
Zanesville, OH 437011406
Phone: (740) 454-5000
Type: Location
410 W 10th Ave
Columbus, OH 432101240
Phone: (614) 293-8000
Type: Location
111 S Grant Ave
Columbus, OH 432154701
Phone: (614) 566-9000
Type: Location
5100 W Broad St
Columbus, OH 432281607
Phone: (614) 544-1000
Type: Location
335 Glessner Ave
Mansfield, OH 449032269
Phone: (419) 526-8581
Fax: (419) 526-8136
Type: Location
272 Hospital Rd
Chillicothe, OH 456019031
Phone: (740) 779-7500
Type: Location
500 London Ave
Marysville, OH 430405512
Phone: (937) 578-2284
Type: Location
600 N Pickaway St
Circleville, OH 431131447
Phone: (740) 474-2126
Type: Location
1010 Refugee Rd
Pickerington, OH 431479653
Phone: (614) 788-4000
Type: Location
1000 McKinley Park Dr
Marion, OH 433026399
Phone: (740) 383-8400
Type: Location
6001 E Broad St
Columbus, OH 432131502
Phone: (614) 234-6000
Type: Location
5300 N Meadows Dr
Grove City, OH 431232546
Phone: (614) 663-5000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2003-11-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-07-31 (310 days ago).
Enrollment records
1
Earliest due date
2025-07-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20031124000198 | O | Clinic/Group Practice | OH | 2025-07-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 43215)
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