NPIMap

Organization Active NPI

Sandeep Kapoor, PLLC

  • Primary Care Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1235469255
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
SANDEEP KAPOOR, PLLC
Practice address
2109 Club Vista PL
Louisville, KY 40245-5224
Phone
(502) 931-8331
Fax
(502) 348-3275
NPI assigned
Jan 14, 2010
Last updated
Aug 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Authorized official

Name
Sandeep Kapoor, MDNPI 1043264641
Title
Owner
Phone
(502) 931-8331

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X KY
Adult Health Nurse Practitioner 363LA2200X KY
Family Nurse Practitioner 363LF0000X KY
Primary Care Nurse Practitioner 363LP2300X Primary
Internal Medicine Physician 207R00000X 35485 KY

Addresses

Primary practice location

2109 Club Vista PL
Louisville, KY 40245-5224

Mailing address

PO Box 43896
Louisville, KY 40253-0896
Phone (502) 931-8331

Other practice location 1

3116 Breckenridge Ln
Louisville, KY 40220-2709
Phone (502) 459-9120

Other practice location 2

2100 Millvale Rd
Louisville, KY 40205-1604
Phone (502) 451-0990

Other practice location 3

1871 Midland Trl
Shelbyville, KY 40065-9111
Phone (502) 633-2454

Other identifiers 2

IdentifierTypeStateIssuer
7100300360MedicaidKY
7100237480MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100422000352 KY Part B Supplier - Clinic/Group Practice 6709913742 Receives reassigned benefits from 10 practitioners
Practice locations: Louisville, KY; Shelbyville, KY; Lexington, KY; Greensburg, KY; Bedford, KY
O20200128000920 IN Part B Supplier - Clinic/Group Practice 6709913742 Receives reassigned benefits from 3 practitioners
Practice locations: Clarksville, IN

National Provider Directory

National Provider Directory

Locations

1120 Cristland Rd
Louisville, KY 40214
Phone (502) 367-0104

13700 English Villa Dr
Louisville, KY 40245
Phone (502) 254-2361

3625 Fern Valley Rd
Louisville, KY 40219
Phone (502) 262-5172

936 Barret Ave
Louisville, KY 40204
Phone (502) 584-3729

1871 Midland Trl
Shelbyville, KY 40065
Phone (502) 589-3573

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1263427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723593600000",
    "number": "1235469255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43896",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402530896",
            "telephone_number": "502-931-8331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 CLUB VISTA PL",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402455224",
            "telephone_number": "502-931-8331",
            "fax_number": "502-348-3275"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3116 Breckenridge Ln",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402202709",
            "country_code": "US",
            "telephone_number": "502-459-9120",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 Millvale Rd",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402051604",
            "country_code": "US",
            "telephone_number": "502-451-0990",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1871 Midland Trl",
            "address_purpose": "LOCATION",
            "city": "Shelbyville",
            "state": "KY",
            "postal_code": "400659111",
            "country_code": "US",
            "telephone_number": "502-633-2454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SANDEEP KAPOOR, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-14",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A",
        "authorized_official_last_name": "KAPOOR",
        "authorized_official_first_name": "SANDEEP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-931-8331",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "35485",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100300360",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100237480",
            "state": "KY"
        }
    ],
    "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 Aug 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.