NPIMap

Individual provider Active NPI

Matthew L. Offutt, M.D.

  • Internal Medicine Physician
  • Louisville, KY
National Provider Identifier
1104867456
Registry record updated May 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34028 Issued in KY
Practice address
4423 Bardstown Rd
Louisville, KY 40218-3235
Phone
(502) 495-2400
Fax
(502) 499-3606
NPI assigned
Jun 9, 2006
Last updated
May 21, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2019

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 34028 KY Primary

Addresses

Primary practice location

4423 Bardstown Rd
Louisville, KY 40218-3235

Mailing address

2700 Stanley Gault Parkway 129
Louisville, KY 40223-5176
Phone (502) 253-4900

Other practice location 1

10216 Taylorsville Rd Ste 500
Louisville, KY 40299-3617
Phone (502) 928-2050

Other practice location 2

211 High Point Ct Ste 700
MT Washington, KY 40047-5529
Phone (502) 928-1050

Other identifiers 1

IdentifierTypeStateIssuer
64033400MedicaidKY

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
I20050921000086 KY Practitioner - Internal Medicine 8921032855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Louisville School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

10216 Taylorsville Rd
Louisville, KY 40299-3617

211 High Point CT
Suite 700
Mount Washington, KY 40047-5529
Phone (502) 928-1050

3900 Kresge Way
Louisville, KY 40207-4681

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Jul 1, 2019 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Jul 1, 2019 Accepting new patients

Locations

10216 Taylorsville Rd
Ste 500
Louisville, KY 40299
Phone (502) 297-8900

2700 Stanley Gault Pkwy
Ste 129
Louisville, KY 40223
Phone (502) 253-4900

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

211 High Point Ct
Ste 700
Mt Washington, KY 40047
Phone (502) 928-1050

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 42

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

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1104867456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 STANLEY GAULT PARKWAY 129",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235176",
            "telephone_number": "502-253-4900",
            "fax_number": "502-489-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4423 BARDSTOWN RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402183235",
            "telephone_number": "502-495-2400",
            "fax_number": "502-499-3606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10216 Taylorsville Rd Ste 500",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402993617",
            "country_code": "US",
            "telephone_number": "502-928-2050",
            "fax_number": "502-928-1051",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "211 High Point Ct Ste 700",
            "address_purpose": "LOCATION",
            "city": "MT Washington",
            "state": "KY",
            "postal_code": "400475529",
            "country_code": "US",
            "telephone_number": "502-928-1050",
            "fax_number": "502-928-1051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OFFUTT",
        "first_name": "MATTHEW",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "34028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64033400",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.