NPIMap

Individual provider Active NPI

Margaux Mae Hetzman, MD

  • Internal Medicine Physician
  • Louisville, KY
National Provider Identifier
1083102883
Registry record updated Jun 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
55566 Issued in KY
Practice address
3950 Kresge Way Ste 308
Louisville, KY 40207-4637
Phone
(502) 852-5666
Fax
(502) 852-8980
NPI assigned
Apr 26, 2018
Last updated
Jun 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X TP049 KY
Internal Medicine Physician 207R00000X 55566 KY Primary

Addresses

Primary practice location

3950 Kresge Way Ste 308
Louisville, KY 40207-4637

Mailing address

3950 Kresge Way Ste 308
Louisville, KY 40207-4637
Phone (502) 895-8911

Other identifiers 1

IdentifierTypeStateIssuer
7100606960MedicaidKY

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
I20210803003990 KY Practitioner - Hospitalist 3577890532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Louisville Hospitalist Associates PLLCGroup PAC ID 1456451715, 34 clinicians

Practice addresses (Care Compare)

4001 Kresge Way
Suite 122
Louisville, KY 40207-4640
Phone (502) 593-7103

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55566KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Louisville Hospitalist Associates PLLC CurrentSince Aug 1, 2021 Accepting new patients
Baptist Healthcare System Inc. Past Accepting new patients

Locations

3950 Kresge Way
Ste 308
Louisville, KY 40207
Phone (502) 895-8911

4001 Kresge Way
Ste 122
Louisville, KY 40207
Phone (502) 895-8911

4000 Kresge Way
St Matthews, KY 40207
Phone (502) 459-7902

Organizations & group practices 2

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.

Hospital & facility affiliations 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1524700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1083102883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 KRESGE WAY STE 308",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074637",
            "telephone_number": "502-895-8911",
            "fax_number": "502-895-8977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 KRESGE WAY STE 308",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074637",
            "telephone_number": "502-852-5666",
            "fax_number": "502-852-8980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETZMAN",
        "first_name": "MARGAUX",
        "middle_name": "MAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-26",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "TP049",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "55566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100606960",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.