Individual provider Active NPI

Samantha Tanny Heuer, PA-C

  • Physician Assistant
  • Louisville, KY
National Provider Identifier
1154108256
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
TC030 Issued in KY
Practice address
2800 Breckenridge LN Ste 400
Louisville, KY 40220-1402
Phone
(502) 895-1111
NPI assigned
Sep 12, 2023
Last updated
Sep 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TC030 KY Primary

Addresses

Primary practice location

2800 Breckenridge LN Ste 400
Louisville, KY 40220-1402

Mailing address

642 Baxter Ave Apt 401
Louisville, KY 40204-2270
Phone (606) 465-8715

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231006003130 KY Practitioner - Physician Assistant 6204281470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

2800 Breckenridge LN
Louisville, KY 40220-1402

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

State licenses

LicenseStateTypeSpecialty
TC030KYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Medical Associates Inc CurrentSince Sep 22, 2023 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Sep 22, 2023 Accepting new patients

Locations

2800 Breckenridge Ln
Ste 400
Louisville, KY 40220
Phone (502) 895-1111

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

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1694476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1154108256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 BAXTER AVE APT 401",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402042270",
            "telephone_number": "606-465-8715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 BRECKENRIDGE LN STE 400",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402201402",
            "telephone_number": "502-895-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEUER",
        "first_name": "SAMANTHA",
        "middle_name": "TANNY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-12",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.