| Gastro Office Llc | |
|
4600 Leap Ct Ste 101 Hilliard OH 43026-1171 | |
| (646) 330-9952 | |
| Not Available |
| Full Name | Gastro Office Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4600 Leap Ct Ste 101, Hilliard, Ohio |
| Authorized Official Name and Position | Krishna Rayapudi (OWNER) |
| Authorized Official Contact | 6463309952 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastro Office Llc 13719 Paragon Dr Pickerington OH 43147-7768 Ph: (740) 919-4092 | Gastro Office Llc 4600 Leap Ct Ste 101 Hilliard OH 43026-1171 Ph: (646) 330-9952 |
| NPI Number | 1467961078 |
|---|---|
| Provider Enumeration Date | 09/26/2017 |
| Last Update Date | 09/26/2017 |
| Medicare PECOS PAC ID | 4183983232 |
|---|---|
| Medicare Enrollment ID | O20180123003031 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467961078 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 125110 (Ohio) | Primary |
| Provider Name | Krishna Mohan Rayapudi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1467688093 PECOS PAC ID: 8123163722 Enrollment ID: I20150406001691 |
| Provider Name | Rohan Manoj Modi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1750777207 PECOS PAC ID: 0749599264 Enrollment ID: I20201030001668 |
| Provider Name | Jessica Okey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902573959 PECOS PAC ID: 0547668345 Enrollment ID: I20211008000985 |
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