Mary Lee Pantess, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4005705 Issued in KY

Practice address

924 E Broadway
Louisville, KY 40204-1057

Phone

(502) 200-1335

Fax

(502) 200-8904

NPI assigned

Jun 26, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Mrs. Mary Lee Aboulhosn Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

83.72 of 100Reported as group

Quality

66.02

Promoting interoperability

100

Improvement activities

40

Cost

79.72

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Kiosk Medicine Kentucky LLC

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1205885035
  Medicare reassignment NPD
• Shively First Health Care, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Louisville, KY
  • NPI 1811775679

  Community/Behavioral Health

  Medicare reassignment NPD
• All in Behavioral Health LLC

  • Addiction Medicine (Family Medicine) Physician
  • Louisville, KY
  • NPI 1023852548
  NPD Authorized official

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1043996911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 S JACKSON ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402032431",
            "telephone_number": "502-259-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 E BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402041057",
            "telephone_number": "502-200-1335",
            "fax_number": "502-200-8904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTESS",
        "first_name": "MARY",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-26",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "KY",
            "license": "4005705",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "KY",
            "license": "4005705",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4005705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100912570",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100936110",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "ABOULHOSN",
            "middle_name": "LEE",
            "prefix": "MRS.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sadip Pant, MD
• Tudor Panta, OTR
• Amelia Pantalos, L.AC., LMT
• Diana C. Pantalos, RD
• Stephanie Marie Pantera
• Pantheon Family Services
• Patrick-Jason Panzu, MD
• Georgios Papageorgakopoulos, DDS
• Summer D Papajeski
• John M Papanek, LCSW

• Family Nurse Practitioner in Louisville, KY
• Providers in Louisville, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.