Individual provider Active NPI

Rea Pavate, MD

  • Pulmonary Disease Physician
  • Elizabethtown, KY
National Provider Identifier
1003438953
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
58319 Issued in KY
Practice address
200 Cardinal Dr Ste 413
Elizabethtown, KY 42701-2795
Phone
(270) 706-5787
Fax
(270) 706-5788
NPI assigned
May 14, 2020
Reactivated
Feb 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pulmonary Disease Physician 207RP1001X 58319 KY Primary

Addresses

Primary practice location

200 Cardinal Dr Ste 413
Elizabethtown, KY 42701-2795

Mailing address

9636 River Trail Dr
Louisville, KY 40229-5221
Phone (270) 706-5787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260529001506 KY Practitioner - Pulmonary Disease 4385179886 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1901 Campus PL
Louisville, KY 40299-2308

500 W Jefferson St
Suite 2310
Louisville, KY 40202-2881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1003438953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9636 RIVER TRAIL DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402295221",
            "telephone_number": "270-706-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CARDINAL DR STE 413",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012795",
            "telephone_number": "270-706-5787",
            "fax_number": "270-706-5788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVATE",
        "first_name": "REA",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-14",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "deactivation_date": "2022-01-17",
        "reactivation_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "KY",
            "license": "58319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

Verify at the official NPI Registry.