NPIMap

Individual provider Active NPI

Bryan Jessop Eckerle

  • Neurology Physician
  • Louisville, KY
National Provider Identifier
1023252558
Registry record updated Oct 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
46403 Issued in KY
Practice address
3 Audubon Plaza Dr
LL2
Louisville, KY 40217-1300
Phone
(502) 636-4940
Fax
(502) 636-4941
NPI assigned
Apr 28, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Neurology Physician 2084V0102X 46403 KY
Neurology Physician 2084N0400X 46403 KY Primary

Addresses

Primary practice location

3 Audubon Plaza Dr
LL2
Louisville, KY 40217-1300

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Other identifiers 1

IdentifierTypeStateIssuer
74003114MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150807014209 KY Practitioner - Neurology 4284876566 Reassigns benefits to 2 organizations
I20251022001497 IN Practitioner - NeurologyPractitioner - Other (Physician) 4284876566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Indiana University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, shared by 2 NPIs, 1,368 clinicians

Practice addresses (Care Compare)

2051 Clevidence Blvd
Suite B
Clarksville, IN 47129-2278
Phone (502) 629-2030

3 Audubon Plaza Dr
Suite LL2
Louisville, KY 40217-1360
Phone (502) 636-8095

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Medical Services Foundation, Inc Neurology CurrentSince Jul 10, 2015 Accepting new patients
Community Medical Associates, Inc. CurrentSince Feb 1, 2017 Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
Community Medical Associates, Inc. CurrentSince Feb 1, 2017 Accepting new patients
Community Medical Associates, Inc. Vascular Neurology Past Accepting new patients

Locations

2051 Clevidence Blvd
Clarksville, IN 47129
Phone (812) 280-6650

2051 Clevidence Blvd
Ste B
Clarksville, IN 47129
Phone (502) 629-2030

1373 E State Road 62
#6F
Madison, IN 47250
Phone (502) 629-7181

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

3 Audubon Plaza Dr
Ste 650
Louisville, KY 40217
Phone (502) 634-8356

3999 Dutchmans Ln
Ste 5D
Louisville, KY 40207
Phone (502) 897-1891

3991 Dutchmans Ln
Ste 310
Louisville, KY 40207
Phone (502) 899-6782

3 Audubon Plaza Dr
Ste LL2
Louisville, KY 40217
Phone (502) 636-8005

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

Interoperability endpoints

  • Direct secure messaging: beckerle118620@direct.nortonhealthcare.org

Organizations & group practices 5

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": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1023252558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 AUDUBON PLAZA DR",
            "address_2": "LL2",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171300",
            "telephone_number": "502-636-4940",
            "fax_number": "502-636-4941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKERLE",
        "first_name": "BRYAN",
        "middle_name": "JESSOP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-28",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "KY",
            "license": "46403",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "KY",
            "license": "46403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74003114",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3 Audubon Plaza Dr",
            "address_2": "LL2",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402171300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.