Individual provider Active NPI

Kelly Lukas Roy, PA-C

  • Physician Assistant
  • Louisville, KY
National Provider Identifier
1043706013
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
100 E Liberty St Ste 700
Louisville, KY 40202-1439
Phone
(502) 583-5836
Fax
(502) 583-2266
NPI assigned
Jul 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

100 E Liberty St Ste 700
Louisville, KY 40202-1439

Mailing address

100 E Liberty St Ste 700
Louisville, KY 40202-1439
Phone (502) 583-5836

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.98 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
66.61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Emergency Medical Specialists, P.S.C. Physician Assistant CurrentSince Oct 1, 2018 Accepting new patients

Locations

1 Audubon Plaza Dr
Louisville, KY 40217
Phone (502) 634-6767

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": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1043706013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LIBERTY ST STE 700",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021439",
            "telephone_number": "502-583-5836",
            "fax_number": "502-583-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LIBERTY ST STE 700",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021439",
            "telephone_number": "502-583-5836",
            "fax_number": "502-583-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY",
        "first_name": "KELLY",
        "middle_name": "LUKAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.