Individual provider Active NPI

Michael Paul Hendricks, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Lexington, KY
National Provider Identifier
1023675964
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
59373 Issued in KY
Practice address
2195 Harrodsburg Rd FL 2
Lexington, KY 40504-3516
Phone
(859) 562-1868
Fax
(859) 257-0421
NPI assigned
May 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 59373 KY Primary

Addresses

Primary practice location

2195 Harrodsburg Rd FL 2
Lexington, KY 40504-3516

Mailing address

571 S Floyd St Ste 432
Louisville, KY 40202-3877

Other practice location 1

571 S Floyd St Ste 432
Louisville, KY 40202-3877
Phone (502) 629-8828

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
I20240709004139 KY Practitioner - Neurology 1557750767 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Kentucky College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kentucky Medical Services Foundation, IncGroup PAC ID 5698689909, 949 clinicians

Practice addresses (Care Compare)

2195 Harrodsburg Rd
Lexington, KY 40504-3504
Phone (859) 257-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
59373KYMDNeurology with Special Qualifications in Child Neurology Physician
TP121KYMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky CurrentSince Jun 12, 2024 Accepting new patients
Kentucky Medical Services Foundation, Inc CurrentSince Jun 12, 2024 Accepting new patients
University of Kentucky Past Accepting new patients
Commission for Children With Special Health Car Past Accepting new patients

Locations

2195 Harrodsburg Rd
Ste 2
Lexington, KY 40504
Phone (859) 323-8082

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

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

2195 Harrodsburg Rd
Lexington, KY 40504
Phone (859) 323-2232

Interoperability endpoints

  • Direct secure messaging: mhendricks350768@ukhcdirect.org

Organizations & group practices 4

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": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1023675964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 S FLOYD ST STE 432",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402023877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2195 HARRODSBURG RD FL 2",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043516",
            "telephone_number": "859-562-1868",
            "fax_number": "859-257-0421"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "571 S Floyd St Ste 432",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402023877",
            "country_code": "US",
            "telephone_number": "502-629-8828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "MICHAEL",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-28",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "KY",
            "license": "59373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.