Stacy Alan Brethauer (NPI# 1043363989, PAC ID# 6002845781) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1043363989 |
| PAC ID by PECOS | 6002845781 |
| Professional Enrollment ID | I20050812000210 |
| Full Name | Stacy Alan Brethauer |
| Organization Legal Name | OSU SURGERY, LLC |
| Address |
2050 Kenny Rd Columbus OH 43221-3502 |
| Phone Number | 6143666675 |
| Gender | M |
| Credential | MD |
| Medical School | UNIFORMED SERVICES UNIVERSITY OF THE HEALTH SCIENCES |
| Graduation Year | 1993 |
| Primary Specialty | GENERAL SURGERY |
| Group Practice PAC ID | 0941105266 |
| Number of Group Practice Members | 146 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 360085 | OHIO STATE UNIVERSITY STATE HEALTH SYSTEM |
| Address | Phone | Organization |
|---|---|---|
| 2050 Kenny Rd, Columbus, OH 43221-3502 | 6143666675 | OSU SURGERY, LLC |
| Organization Legal Name | OSU SURGERY, LLC |
| Physicians | 154 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amber L Traugott | Colorectal Surgery (proctology) | Osu Surgery, LLC | 4830 Knightsbridge Blvd J, Columbus, OH 43214-4322 |
| Syed G Husain | Colorectal Surgery (proctology) | Osu Surgery, LLC | 1492 E Broad St, Columbus, OH 43205-1546 |
| Priya Harakh Dedhia | General Surgery | Osu Surgery, LLC | 2050 Kenny Rd, Columbus, OH 43221-3502 |
| Asvin Minoo Ganapathi | Cardiac Surgery | Osu Surgery, LLC | 410 W 10th Ave, Columbus, OH 43210-1228 |
| Ihab O Elhassan | General Surgery | Osu Surgery, LLC | 410 W 10th Ave, Columbus, OH 43210-1228 |
| Kirsten Tychonievich | Nurse Practitioner | Osu Surgery, LLC | 2050 Kenny Rd, Columbus, OH 43221-3502 |
| Nahush A Mokadam | Cardiac Surgery | Osu Surgery, LLC | 410 W 10th Ave, Columbus, OH 43210-1228 |
| Shannon M Greaker | Nurse Practitioner | Osu Surgery, LLC | 2050 Kenny Rd, Columbus, OH 43221-3502 |
| Bradley J Needleman | General Surgery | Osu Surgery, LLC | 460 W 10th Ave, Columbus, OH 43210-1240 |
| Randi Denise Winenger | Nurse Practitioner | Osu Surgery, LLC | 300 W 10th Ave, Columbus, OH 43210-1280 |
| Street Address |
2050 KENNY RD |
| City | COLUMBUS |
| State | OH |
| Zip | 43221-3502 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniel J Kim | Physical Medicine and Rehabilitation | Osu Physical Medicine and Rehabilitation, LLC | 2050 Kenny Rd, Columbus, OH 43221-3502 |
| Priya Harakh Dedhia | General Surgery | Osu Surgery, LLC | 2050 Kenny Rd, Columbus, OH 43221-3502 |
| Ye Zhou | Nurse Practitioner | Osu Internal Medicine, LLC | 2050 Kenny Rd, Columbus, OH 43221-3502 |
| William S Pease | Physical Medicine and Rehabilitation | Osu Physical Medicine and Rehabilitation, LLC | 2050 Kenny Rd, Columbus, OH 43221-3502 |
| Sandra K Kostyk | Neurology | Osu Neuroscience Center, LLC | 2050 Kenny Rd, Fl 7, Columbus, OH 43221-3502 |
| Troy Allen Schaffernocker | Pulmonary Disease | Osu Internal Medicine, LLC | 2050 Kenny Rd, Columbus, OH 43221-3502 |
| Kirsten Tychonievich | Nurse Practitioner | Osu Surgery, LLC | 2050 Kenny Rd, Columbus, OH 43221-3502 |
| Michael J Wert | Internal Medicine | Osu Internal Medicine, LLC | 2050 Kenny Rd, Columbus, OH 43221-3502 |
| Shannon M Greaker | Nurse Practitioner | Osu Surgery, LLC | 2050 Kenny Rd, Columbus, OH 43221-3502 |
| Julie Luann Mohr | Nurse Practitioner | Osu Internal Medicine, LLC | 2050 Kenny Rd, Columbus, OH 43221-3502 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Patricia A Child | Psychologist, Clinical | 3400 Kenny Rd, Columbus, OH 43221-1500 | |
| Mary Steed-may | Clinical Social Worker | 3400 Kenny Rd, Columbus, OH 43221-1500 | |
| James Gebhart | Psychologist, Clinical | 3400 Kenny Rd, Columbus, OH 43221-1500 | |
| Megan G Thomas | Psychologist, Clinical | 3400 Kenny Rd, Columbus, OH 43221-1500 | |
| Patricia Ann Smith | Psychologist, Clinical | 3400 Kenny Rd, Columbus, OH 43221-1500 | |
| Rahe Corlis | Psychologist, Clinical | 3400 Kenny Rd, Columbus, OH 43221-1500 | |
| Katherine Scullion | Optometry | Riverside Eye Center LLC | 3434 Riverside Dr, Upper Arlington, OH 43221-1743 |
| Darrell D Dye | Optometry | Riverside Eye Center LLC | 3434 Riverside Dr, Upper Arlington, OH 43221-1743 |
| Eric Dean Ostrem | Optometry | 3220 Riverside Dr, Suite B1, Upper Arlington, OH 43221-1752 | |
| Robert P Egbert | Clinical Social Worker | Wellqor Psychological Services PC | 3500 Riverside Dr, Upper Arlington, OH 43221-1753 |
| Find all physicians in zip 43221 | |||
| City | COLUMBUS |
| Zip Code | 43221 |
| Specialty | GENERAL SURGERY |
| City + Specialty | COLUMBUS + GENERAL SURGERY |
Please comment or provide details below to improve the information on Stacy Alan Brethauer.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.