NPIMap

Individual provider Active NPI

Bradley William Ott, CRNA

  • Certified Registered Nurse Anesthetist
  • Louisville, KY
National Provider Identifier
1205863750
Registry record updated Apr 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3004551 Issued in KY
Practice address
200 Abraham Flexner Way
Anesthesia Department
Louisville, KY 40202-2877
Phone
(502) 587-4404
Fax
(502) 587-4156
NPI assigned
Jun 27, 2006
Last updated
Apr 5, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 3004551 KY Primary

Addresses

Primary practice location

200 Abraham Flexner Way
Anesthesia Department
Louisville, KY 40202-2877

Mailing address

100 E Liberty St Ste 800
Louisville, KY 40202-1428
Phone (502) 587-4404

Other identifiers 2

IdentifierTypeStateIssuer
74009945MedicaidKY
200512440AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050404000492 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 2567419401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 Abraham Flexner Way
Louisville, KY 40202-1886
Phone (502) 587-4401

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Nov 1, 2019 Accepting new patients
University of Louisville Physicians, Inc. Current Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Nov 1, 2019 Accepting new patients
Anesthesia Associates of Louisville, PSC Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

200 Abraham Flexner Way
Louisville, KY 40202
Phone (502) 569-7983

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

5100 Outer Loop
Louisville, KY 40219
Phone (502) 968-6226

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

Organizations & group practices 4

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 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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1205863750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LIBERTY ST STE 800",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021428",
            "telephone_number": "502-587-4404",
            "fax_number": "502-587-4156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ABRAHAM FLEXNER WAY",
            "address_2": "ANESTHESIA DEPARTMENT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022877",
            "telephone_number": "502-587-4404",
            "fax_number": "502-587-4156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTT",
        "first_name": "BRADLEY",
        "middle_name": "WILLIAM",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "3004551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74009945",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200512440A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.