Individual provider Active NPI

Tathyana Marques F Fensterer, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Louisville, KY
National Provider Identifier
1225337934
Registry record updated May 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
52168 Issued in KY
Practice address
2507 Bush Ridge Dr Ste B
Louisville, KY 40245
Phone
(502) 589-8000
Fax
(502) 589-8001
NPI assigned
Mar 21, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0122X 52168 KY Primary

Addresses

Primary practice location

2507 Bush Ridge Dr Ste B
Louisville, KY 40245

Mailing address

2507 Bush Ridge Dr Ste B
Louisville, KY 40245-5885
Phone (502) 589-8000

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
I20190523002708 KY Practitioner - Plastic and Reconstructive Surgery 8921391368 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, shared by 31 NPIs, 2,431 clinicians

Practice addresses (Care Compare)

3950 Kresge Way
Suite 100
Louisville, KY 40207-4637
Phone (502) 897-0269

511 Robinbrooke Blvd
Suite 100
Elizabethtown, KY 42701-5904
Phone (270) 706-1945

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy20
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc Multi-Specialty Current Accepting new patients
Baptist Medical Associates Inc CurrentSince Nov 15, 2021 Accepting new patients
Baptist Health Medical Group Inc Multi-Specialty CurrentSince Oct 1, 2021 Accepting new patients
Baptist Health Medical Group Inc Multi-Specialty CurrentSince Oct 1, 2021 Accepting new patients

Locations

511 Robinbrooke Blvd
Ste 100
Elizabethtown, KY 42701
Phone (270) 706-1945

3950 Kresge Way
Ste 100
Louisville, KY 40207
Phone (502) 583-8383

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

2603 Kentucky Ave
Ste 304
Paducah, KY 42003
Phone (270) 415-4800

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 1

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": "1300665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557446400000",
    "number": "1225337934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2507 BUSH RIDGE DR STE B",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402455885",
            "telephone_number": "502-589-8000",
            "fax_number": "502-589-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2507 BUSH RIDGE DR STE B",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40245",
            "telephone_number": "502-589-8000",
            "fax_number": "502-589-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENSTERER",
        "first_name": "TATHYANA",
        "middle_name": "MARQUES F",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-21",
        "last_updated": "2019-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "KY",
            "license": "52168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.