NPIMap

Individual provider Active NPI

Erica Mamauag

  • Pediatric Hematology & Oncology Physician
  • Louisville, KY
National Provider Identifier
1134652035
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
59655 Issued in KY
Practice address
411 E Chestnut St # 4B
Louisville, KY 40202-1713
Phone
(502) 588-3600
Fax
(502) 588-9536
NPI assigned
Apr 6, 2017
Last updated
Jul 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Student in an Organized Health Care Education/Training Program 390200000X MD475044 PA
Pediatrics Physician 208000000X 59655 KY
Pediatric Hematology & Oncology Physician 2080P0207X 59655 KY Primary

Addresses

Primary practice location

411 E Chestnut St # 4B
Louisville, KY 40202-1713

Mailing address

PO Box 776879
Chicago, IL 60677-6879
Phone (502) 588-9490

Other practice location 1

2401 Terra Crossing Blvd Ste 202
Louisville, KY 40245-5395
Phone (502) 210-4301

Other practice location 2

4401 Penn Avenue
Plaza Building, Floor 5, Room 506
Pittsburgh, PA 15224
Phone (412) 692-7608

Other practice location 3

500 S Preston St Rm 305
Louisville, KY 40202-1702
Phone (502) 852-8696

Other identifiers 1

IdentifierTypeStateIssuer
59655OtherKYSTATE LICENSE

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
I20241011001743 KY Practitioner - Hematology/Oncology 7719388511 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
University of Louisville School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

411 E Chestnut St
Level 4B
Louisville, KY 40202-1713
Phone (502) 588-3600

Hospital & facility affiliations

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
59655KYMDPediatric Hematology & Oncology Physician
MD475044PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Mar 1, 2025 Accepting new patients
University of Louisville Physicians, Inc. Pediatrics Current Accepting new patients
Norton Children's Medical Group, LLC Current Accepting new patients
Norton Children's Medical Group, LLC Pediatrics CurrentSince Oct 1, 2024 Accepting new patients
Norton Children's Medical Group, LLC CurrentSince Oct 1, 2024 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Mar 1, 2025 Accepting new patients
Norton Childrens Medical Group, LLC Pediatrics Past Accepting new patients
Norton Hospitals, Inc Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

2401 Terra Crossing Blvd
Ste 101
Louisville, KY 40245
Phone (502) 210-4600

2401 Terra Crossing Blvd
Ste 202
Louisville, KY 40245
Phone (502) 210-4301

411 E Chestnut St
#4B
Louisville, KY 40202
Phone (502) 588-3600

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

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

Interoperability endpoints

  • Direct secure messaging: emamauag103317@direct.nortonhealthcare.org

Organizations & group practices 8

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1134652035",
    "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": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 E CHESTNUT ST # 4B",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021713",
            "telephone_number": "502-588-3600",
            "fax_number": "502-588-9536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 Terra Crossing Blvd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402455395",
            "country_code": "US",
            "telephone_number": "502-210-4301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4401 Penn Avenue",
            "address_2": "Plaza Building, Floor 5, Room 506",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "15224",
            "country_code": "US",
            "telephone_number": "412-692-7608",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 S Preston St Rm 305",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021702",
            "country_code": "US",
            "telephone_number": "502-852-8696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAMAUAG",
        "first_name": "ERICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-06",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MD475044",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "59655",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "KY",
            "license": "59655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "59655",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.