NPIMap

Individual provider Active NPI

Cynthia Romer Fata, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Louisville, KY
National Provider Identifier
1013144179
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
55551 Issued in KY
Practice address
231 E Chestnut St
Louisville, KY 40202-1821
Phone
(502) 456-6211
Fax
(502) 456-4440
NPI assigned
Jun 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 55551 KY Primary
Pediatric Pathology Physician 207ZP0213X 55551 KY

Addresses

Primary practice location

231 E Chestnut St
Louisville, KY 40202-1821

Mailing address

1941 Bishop LN Ste 1018
Louisville, KY 40218-1928
Phone (502) 456-6211

Other names 1

  • Cynthia Soldevilla Romer Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210920002903 KY Practitioner - Pathology 7719289461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of South Florida College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatric and Perinatal Pathology Associates PSCGroup PAC ID 5294708285, 5 clinicians

Practice addresses (Care Compare)

231 E Chestnut St
Suite 260
Louisville, KY 40202-1821
Phone (502) 456-6217

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55551KYMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric and Perinatal Pathology Associates PSC Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2021 Accepting new patients

Locations

1941 Bishop Ln
Ste 1018
Louisville, KY 40218

231 E Chestnut St
Ste 260
Louisville, KY 40202
Phone (502) 456-6217

231 E Chestnut St
Louisville, KY 40202
Phone (502) 852-8500

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1013144179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 BISHOP LN STE 1018",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402181928",
            "telephone_number": "502-456-6211",
            "fax_number": "502-456-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 E CHESTNUT ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021821",
            "telephone_number": "502-456-6211",
            "fax_number": "502-456-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATA",
        "first_name": "CYNTHIA",
        "middle_name": "ROMER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-16",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KY",
            "license": "55551",
            "primary": true
        },
        {
            "code": "207ZP0213X",
            "taxonomy_group": "",
            "desc": "Pathology, Pediatric Pathology",
            "state": "KY",
            "license": "55551",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYNTHIA",
            "last_name": "ROMER",
            "middle_name": "SOLDEVILLA",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.