Individual provider Active NPI

Tomasz Kobylanski, MD

  • Internal Medicine Physician
  • Louisville, KY
National Provider Identifier
1073539847
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
37572 Issued in KY
Practice address
8019 Dixie Hwy Ste 101
Louisville, KY 40258-1303
Phone
(502) 333-3121
Fax
(502) 531-9538
NPI assigned
Jul 14, 2006
Last updated
Jun 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01058945A IN
Internal Medicine Physician 207R00000X 37572 KY Primary

Addresses

Primary practice location

8019 Dixie Hwy Ste 101
Louisville, KY 40258-1303

Mailing address

8019 Dixie Hwy Ste 101
Louisville, KY 40258-1303
Phone (502) 333-3121

Other identifiers 2

IdentifierTypeStateIssuer
100180890GMedicaidIN
200400730MedicaidIN

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
I20230608001570 KY Practitioner - Internal Medicine 5991796518 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
PMR Ky Holding, LLC CurrentSince Jul 1, 2023 Accepting new patients

Locations

2406 W Broadway
Louisville, KY 40211
Phone (502) 775-1211

3939 7th Street Rd
Louisville, KY 40216
Phone (502) 775-1211

8019 Dixie Hwy
Ste 101
Louisville, KY 40258
Phone (502) 333-3121

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1073539847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8019 DIXIE HWY STE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402581303",
            "telephone_number": "502-333-3121",
            "fax_number": "502-531-9538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8019 DIXIE HWY STE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402581303",
            "telephone_number": "502-333-3121",
            "fax_number": "502-531-9538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBYLANSKI",
        "first_name": "TOMASZ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01058945A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "37572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100180890G",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200400730",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.