Individual provider Active NPI

Maral Mehraban, APRN

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1194513556
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4043455 Issued in KY
Practice address
1850 Bluegrass Ave
Louisville, KY 40215-1161
Phone
(502) 361-6391
NPI assigned
Apr 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 1172500 KY
Family Nurse Practitioner 363LF0000X 4043455 KY Primary

Addresses

Primary practice location

1850 Bluegrass Ave
Louisville, KY 40215-1161

Mailing address

1850 Bluegrass Ave
Louisville, KY 40215-1161
Phone (502) 361-6391

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
I20251021003848 KY Practitioner - Nurse Practitioner 7315435435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Louisville School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

1850 Bluegrass Ave
Louisville, KY 40215-1199
Phone (502) 361-6000

Hospital & facility affiliations

  • UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Hospital, Louisville, KY, CCN 180040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1172500KYMDEmergency Registered Nurse
4043455KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC CurrentSince Nov 1, 2025 Accepting new patients

Locations

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

1850 Bluegrass Ave
Louisville, KY 40215
Phone (502) 361-6617

3920 Dutchmans Ln
Louisville, KY 40207
Phone (502) 259-6000

727 Hospital Dr
Shelbyville, KY 40065
Phone (502) 633-2345

Organizations & group practices 1

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.

Hospital & facility affiliations 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1745798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1194513556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 BLUEGRASS AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402151161",
            "telephone_number": "502-361-6391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 BLUEGRASS AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402151161",
            "telephone_number": "502-361-6391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHRABAN",
        "first_name": "MARAL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-28",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "KY",
            "license": "1172500",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4043455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.