Individual provider Active NPI

Howard Fishkoff, DO

  • Psychiatry Physician
  • Louisville, KY
National Provider Identifier
1144277476
Registry record updated Nov 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
02730 Issued in KY
Practice address
101 W Muhammad Ali Blvd
Louisville, KY 40202-1423
Phone
(502) 589-8600
Fax
(502) 287-0662
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 02730 KY Primary

Addresses

Primary practice location

101 W Muhammad Ali Blvd
Louisville, KY 40202-1423

Mailing address

101 W Muhammad Ali Blvd
Louisville, KY 40202-1423
Phone (502) 589-8600

Other identifiers 4

IdentifierTypeStateIssuer
000000578416OtherKYBCBS PIN#
7100057550MedicaidKY
47037877928MedicaidNE
200939350MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20240805003685 IA Practitioner - Psychiatry 8325041759 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation CurrentSince Sep 9, 2024 Accepting new patients
Box Butte General Hospital Past Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

700 E University Ave
Ste 3W
Des Moines, IA 50316

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446768000000",
    "number": "1144277476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W MUHAMMAD ALI BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021423",
            "telephone_number": "502-589-8600",
            "fax_number": "502-287-0662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W MUHAMMAD ALI BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021423",
            "telephone_number": "502-589-8600",
            "fax_number": "502-287-0662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHKOFF",
        "first_name": "HOWARD",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2015-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "02730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN#",
            "identifier": "000000578416",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100057550",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47037877928",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200939350",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.