DR. LARISA RAVITSKIY (NPI# 1144230905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144230905 |
| Entity Type | Individual |
| Full Name | DR. LARISA RAVITSKIY |
| Credential | MD |
| Practice Address |
602 Morrison Rd Gahanna OH 43230 |
| Mailing Address |
602 Morrison Rd Gahanna OH 43230-5342 |
| Practice Telephone | 6145859900 |
| Practice Fax Number | 6145859999 |
| Mailing Telephone | 6145859900 |
| Mailing Fax Number | 6145859999 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2015-04-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | 41743 | AZ | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | 35092083 | OH | Allopathic & Osteopathic Physicians |
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
35092083 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2901560 | 05 |
| Street Address |
602 MORRISON RD |
| City | GAHANNA |
| State | OH |
| Zip Code | 43230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508197112 | Ohio Skin Cancer Institute LLC | Dermatology | 602 Morrison Rd, Gahanna, OH 43230-5342 | 2010-01-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013518695 | Adonna Fuller | Technician | 14o Imperial Drive, Apt 120, Gahanna, OH 43230 | 2020-11-02 |
| 1407471733 | Brent Flory | Counselor | 425 South Hamilton, Gahanna, OH 43230 | 2020-06-12 |
| 1245865252 | Amy Marie Cosma | Registered Nurse | 750 Cross Pointe Road, Suite D, Gahanna, OH 43230 | 2020-03-10 |
| 1447718010 | Yolanda Renee Davis | Case Manager/Care Coordinator | 1490 E Main St., Columbus, OH 43230 | 2019-03-03 |
| 1699261537 | Cap City Supported Living & Homecare Services, LLC | Home Health | 2305 South Hamilton Road, Suite 216, Columbus, OH 43230 | 2018-07-03 |
| 1467957183 | Kendra Marie Peterson | Specialist/Technologist | 1011 Arcaro Drive, Gahanna, OH 43230 | 2018-03-26 |
| 1467956805 | Beatrice Njeri Gachoro | Registered Nurse | 4484 Shady Blossom Ln, Columbus, OH 43230 | 2018-03-21 |
| 1760900211 | Centra Home Health Care, LLC | Home Health | 4745 Legare Ln, Columbus, OH 43230 | 2017-09-05 |
| 1386164325 | Ziad Al Hennawi | Dentist | 4034 Morse Rd, Columbus, OH 43230 | 2017-06-21 |
| 1336675503 | Fresenius Medical Care New Albany, LLC | Clinic/Center | 991 E Johnstown Rd, Gahanna, OH 43230 | 2017-05-10 |
| Find all providers in zip 43230 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508197112 | Ohio Skin Cancer Institute LLC | Dermatology | 602 Morrison Rd, Gahanna, OH 43230-5342 | 2010-01-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689973638 | Apex Dermatology and Skin Surgery Center LLC | Dermatology | 7580 Auburn Road, Suite 301, Tripoint Medical Center, Physician Pavillion, Painesville, OH 44077 | 2011-03-16 |
| 1235442211 | Dermatology & Surgery of Southern Ohio, Inc. | Dermatology | 7132 Cincinnati Dayton Rd, Suite 200, Liberty Townshp, OH 45069-1775 | 2010-07-20 |
| 1619070224 | West Ohio Dermatology, Inc. | Dermatology | 750 W High St Ste 300, Lima, OH 45801-2967 | 2006-09-07 |
| 1912910803 | Harry Michael Humeniuk | Dermatology | 4935 Harroun Rd, Sylvania, OH 43560-2107 | 2006-08-14 |
| 1891783494 | Henry Michael Duke | Dermatology | 6210 N Main St, Dayton, OH 45415-3111 | 2005-10-10 |
| 1952307324 | Jennifer L Popovsky | Dermatology | 1133 Medina Rd Ste 100, Medina, OH 44256-5913 | 2005-06-21 |
| 1356884837 | Bravia Dermatology Group, LLC | Dermatology | 2000 Regency Ct, Suite #201, Toledo, OH 43623-3090 | 2016-12-01 |
| 1932592698 | Allied Dermatology and Skin Surgery, LLC | Dermatology | 3624 W Market St Ste 101, Fairlawn, OH 44333-4510 | 2015-03-05 |
| 1205104601 | Dermatologic Surgery Center of Northeast Ohio Inc | Dermatology | 1133 Medina Rd, Suite 100, Medina, OH 44256-0000 | 2011-12-13 |
| 1942433065 | Columbus Skin Surgery Center, Inc. | Dermatology | 6670 Perimeter Dr, Suite 260, Dublin, OH 43016-8056 | 2009-08-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.