Individual provider Active NPI

Mary E Fallat, M.D.

  • Pediatric Surgery Physician
  • Louisville, KY
National Provider Identifier
1124025127
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
21050 Issued in KY
Practice address
411 E Chestnut St
Louisville, KY 40202-1713
Phone
(502) 588-0390
Fax
(502) 588-0396
NPI assigned
Jul 5, 2005
Last updated
Jul 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X 21050 KY Primary

Addresses

Primary practice location

411 E Chestnut St
Louisville, KY 40202-1713

Mailing address

PO Box 776879
Chicago, IL 60677-6879
Phone (502) 588-0390

Other identifiers 2

IdentifierTypeStateIssuer
100330770MedicaidIN
64210503MedicaidKY

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mfallat40019@direct.nortonhealthcare.org
FHIR URL https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/

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
I20110209000898 KY Practitioner - Pediatric MedicinePractitioner - Other (Physician) 4385824267 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
97.07
Promoting interoperability
100
Improvement activities
40
Cost
76.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21050KYMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Children's Medical Group, LLC CurrentSince Mar 1, 2020 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Dec 1, 2012 Accepting new patients
University of Louisville Physicians, Inc. Current Accepting new patients
Norton Children's Medical Group, LLC Current Accepting new patients
Norton Children's Medical Group, LLC CurrentSince Mar 1, 2020 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Dec 1, 2012 Accepting new patients
Norton Childrens Medical Group, LLC Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

234 E Gray St
Ste 766
Louisville, KY 40202
Phone (502) 583-7337

411 E Chestnut St
Louisville, KY 40202
Phone (502) 588-2330

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

Organizations & group practices 7

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1124025127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776879",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776879",
            "telephone_number": "502-588-0390",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 E CHESTNUT ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021713",
            "telephone_number": "502-588-0390",
            "fax_number": "502-588-0396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLAT",
        "first_name": "MARY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "KY",
            "license": "21050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100330770",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64210503",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mfallat40019@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "234 E Gray St",
            "address_2": "Ste 766",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402021901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "234 E Gray St",
            "address_2": "Ste 766",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402021901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.