NPIMap

Individual provider Active NPI

Neeraj Mahboob, MD

  • Internal Medicine Physician
  • Frankfort, KY
National Provider Identifier
1073524062
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
36255 Issued in KY
Practice address
601 Versailles Rd
Frankfort, KY 40601-3857
Phone
(502) 695-3946
Fax
(877) 569-3088
NPI assigned
Aug 11, 2006
Last updated
Feb 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 36255 KY Primary

Addresses

Primary practice location

601 Versailles Rd
Frankfort, KY 40601-3857

Mailing address

6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168

Other practice location 1

515 Memorial Dr
Ste 3
Manchester, KY 40962-9157
Phone (606) 599-0864

Other identifiers 1

IdentifierTypeStateIssuer
64-023260MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address neeraj.mahboob.1@29601.direct.athenahealth.com

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
I20040901001198 KY Practitioner - Internal Medicine 8022901792 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Proactive Therapy, IncGroup PAC ID 0143245415, 118 clinicians

Practice addresses (Care Compare)

1004 Leawood Dr
Frankfort, KY 40601-3349
Phone (502) 223-7403

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36255KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Research Foundation Inc CurrentSince Jun 18, 2025 Accepting new patients
Centerwell Senior Primary Care Ky PSC Internal Medicine Current Accepting new patients
University of Louisville Research Foundation, Inc. CurrentSince Jun 18, 2025 Accepting new patients
Neeraj Mahboob Internal Medicine PSC Internal Medicine CurrentSince Nov 18, 2002 Accepting new patients
University of Louisville Research Foundation Inc Internal Medicine Current Accepting new patients
Centerwell Senior Primary Care Ky PSC Internal Medicine CurrentSince Nov 10, 2025 Accepting new patients
Georgia Clinic, PC CurrentSince Aug 1, 2023 Accepting new patients
Centerwell Senior Primary Care (Ky) PSC Internal Medicine CurrentSince Nov 10, 2025 Accepting new patients
Centerwell Senior Primary Care Ky PSC Internal Medicine Past Accepting new patients
Landmark of Laurel Creek Rehabilitation and Nursing Center Past Accepting new patients
The Medical Specialists of Ky, PSC Past Accepting new patients
Christian Cardiology Internal Medicine Past Accepting new patients

Locations

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

11378 State Bridge Rd
Alpharetta, GA 30022
Phone (678) 799-6043

1861 Peeler Rd
Ste 100
Dunwoody, GA 30338
Phone (770) 730-5800

6330 Primrose Hill Ct
Peachtree Corners, GA 30092
Phone (770) 309-8108

601 Versailles Rd
Frankfort, KY 40601
Phone (502) 695-3946

215 Central Ave
Ste 110
Louisville, KY 40208
Phone (502) 852-5205

3151 S 2nd St
Louisville, KY 40208
Phone (502) 632-9313

517 S Floyd St
100
Louisville, KY 40202
Phone (502) 852-5333

515 Memorial Dr
Ste 3
Manchester, KY 40962
Phone (606) 599-0169

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: neeraj.mahboob.1@29601.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Medical Associates of Southeast KentuckyManchester, KY, CCN 188900 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer (100%)
Corporate Director (100%)
W-2 Managing Employee (100%)		 Nov 13, 2009
Nov 13, 2009
Nov 13, 2009
Nov 13, 2009

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Neeraj Mahboob Internal Medicine PSC

    dba Medical Associates of Southeast Kentucky

    • Rural Health Clinic/Center
    • Manchester, KY
    • NPI 1407867484

    5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee

    CMS ownership

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1073524062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 VERSAILLES RD",
            "city": "FRANKFORT",
            "state": "KY",
            "postal_code": "406013857",
            "telephone_number": "502-695-3946",
            "fax_number": "877-569-3088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 Memorial Dr",
            "address_2": "Ste 3",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "KY",
            "postal_code": "409629157",
            "country_code": "US",
            "telephone_number": "606-599-0864",
            "fax_number": "606-599-0869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHBOOB",
        "first_name": "NEERAJ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "36255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64-023260",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "neeraj.mahboob.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "601 Versailles Rd",
            "city": "Frankfort",
            "state": "KY",
            "country_code": "US",
            "postal_code": "406013857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Frankfort, KY

Sources for this page

Verify at the official NPI Registry.