Individual provider Active NPI

Patricia Danielle Walsh, PA-C

  • Physician Assistant
  • Newport, KY
National Provider Identifier
1215586193
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2437 Issued in KY
Practice address
1400 Grand Avenue
Newport, KY 41071-2570
Phone
(859) 212-0497
NPI assigned
Sep 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.007248 IL
Physician Assistant 363A00000X PA2437 KY Primary

Addresses

Primary practice location

1400 Grand Avenue
Newport, KY 41071-2570

Mailing address

PO Box 776879
Chicago, IL 60677-6213
Phone (502) 588-9490

Other practice location 1

1600 N Randall Rd Ste 201
Elgin, IL 60123-7805
Phone (847) 382-5080

Other practice location 2

360 Station Dr Ste 110
Crystal Lake, IL 60014-7978
Phone (847) 382-5080

Other practice location 3

22285 N Pepper Rd Ste 201
Lake Barrington, IL 60010-2540
Phone (847) 382-5080

Other practice location 4

4123 Dutchmans Ln Ste 102
Louisville, KY 40207-4718
Phone (502) 559-1670

Other practice location 5

7370 Turfway Road
Florence, KY 41042-4824
Phone (859) 212-0497

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
I20220103001888 KY Practitioner - Physician Assistant 3779815717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

1400 Grand Ave
Newport, KY 41071-2570
Phone (859) 301-5901

300 Barnes Rd
Williamstown, KY 41097-9483
Phone (859) 824-8400

PO Box
Suite 635283
Cincinnati, OH 45263-5283

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.007248ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Feb 26, 2024 Accepting new patients
Summit Medical Group, Inc Physician Assistant CurrentSince Feb 26, 2024 Accepting new patients
Summit Medical Group, Inc Physician Assistant Past Accepting new patients
United Shockwave Services, LTD. Past Accepting new patients

Locations

7370 Turfway Rd
Florence, KY 41042
Phone (859) 212-5125

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

1400 Grand Ave
Newport, KY 41071
Phone (859) 905-3070

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1215586193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776879",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776213",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 GRAND AVENUE",
            "city": "NEWPORT",
            "state": "KY",
            "postal_code": "410712570",
            "telephone_number": "859-212-0497"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 N Randall Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601237805",
            "country_code": "US",
            "telephone_number": "847-382-5080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "360 Station Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600147978",
            "country_code": "US",
            "telephone_number": "847-382-5080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22285 N Pepper Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Lake Barrington",
            "state": "IL",
            "postal_code": "600102540",
            "country_code": "US",
            "telephone_number": "847-382-5080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4123 Dutchmans Ln Ste 102",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402074718",
            "country_code": "US",
            "telephone_number": "502-559-1670",
            "fax_number": "502-559-1679",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7370 Turfway Road",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "KY",
            "postal_code": "410424824",
            "country_code": "US",
            "telephone_number": "859-212-0497",
            "fax_number": "859-282-1141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALSH",
        "first_name": "PATRICIA",
        "middle_name": "DANIELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-04",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.007248",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, KY

Sources for this page

Verify at the official NPI Registry.