Individual provider Active NPI

Elvedin Kulenovic, M.D.

  • Diagnostic Radiology Physician
  • Louisville, KY
National Provider Identifier
1174527527
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
37697 Issued in KY
Practice address
530 S Jackson St
# C07
Louisville, KY 40202-1675
Phone
(502) 852-5875
Fax
(502) 852-1754
NPI assigned
Jun 13, 2005
Last updated
Feb 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 37697 KY Primary

Addresses

Primary practice location

530 S Jackson St
# C07
Louisville, KY 40202-1675

Mailing address

PO Box 21249
Louisville, KY 40221-0249
Phone (502) 581-1500

Other identifiers 3

IdentifierTypeStateIssuer
P00125213OtherKYRAILROAD MEDICARE
000000329948OtherKYANTHEM
64076631MedicaidKY

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
I20040331001632 KY Practitioner - Diagnostic Radiology 5991797821 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisivlle Physicians CurrentSince Nov 1, 2012 Accepting new patients
University of Louisville Physicians, Inc. Diagnostic Radiology CurrentSince Nov 1, 2012 Accepting new patients
University of Louisville Physicians, Inc. Current Accepting new patients
University Physicians Group - Radiology Diagnostic Radiology Past Accepting new patients
University Medical Services Foundation Inc Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

530 S Jackson St
#C7
Louisville, KY 40202
Phone (502) 582-5875

550 S Jackson St
Fl 3
Louisville, KY 40202
Phone (502) 561-8686

550 S Jackson St
Fl First
Louisville, KY 40202
Phone (502) 852-0011

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

Organizations & group practices 5

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": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1174527527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21249",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402210249",
            "telephone_number": "502-581-1500",
            "fax_number": "502-540-4959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 S JACKSON ST",
            "address_2": "# C07",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021675",
            "telephone_number": "502-852-5875",
            "fax_number": "502-852-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULENOVIC",
        "first_name": "ELVEDIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "37697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00125213",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000329948",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64076631",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.