Aesthetic Plastic Surgery Institute of Louisville, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

300168 Issued in KY

Legal business name

AESTHETIC PLASTIC SURGERY INSTITUTE OF LOUISVILLE, LLC

Doing business as

Louisville Surgery Center

Practice address

444 S 1St St
Suite 201
Louisville, KY 40202-1416

Phone

(502) 238-2888

Fax

(502) 238-2897

NPI assigned

Aug 22, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark Edward Chariker, M.D.NPI 1194724997

Title

Medical Director

Phone

(502) 568-4800

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Louisville Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Listed as

Louisville Surgery CenterCCN 18C0001039

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• First Urology, PSC

  dba Southern Indiana Radiation Therapy Center

  • Urology Physician
  • Louisville, KY
  • NPI 1104183953

  Member Of

  NPD member

Practitioners 2

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.

• Mark E. Chariker, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Louisville, KY
  • NPI 1194724997
  Authorized official Same address or phone
• Thomas G. O'Daniel Jr., M.D.

  • Plastic and Reconstructive Surgery Physician
  • Louisville, KY
  • NPI 1871585018
  NPD (past)

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245346923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 S 1ST ST",
            "address_2": "SUITE 201",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021416",
            "telephone_number": "502-238-2888",
            "fax_number": "502-238-2897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 S 1ST ST",
            "address_2": "SUITE 201",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021416",
            "telephone_number": "502-238-2888",
            "fax_number": "502-238-2897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AESTHETIC PLASTIC SURGERY INSTITUTE OF LOUISVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHARIKER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "502-568-4800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "KY",
            "license": "300168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36001360",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50006214",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000357022",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Louisville Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aegis Group Practice LLC
• Aegis Group Practice LLC
• Aegis Group Practice LLC
• Gyl Marceline Aengwanama
• Aesthetic and Wellness Dental PLLC
• Aesthetic Specialists PLLC (East Louisville ENT Surgery)
• Aetna Better Health of Kentucky Insurance Company (Aetna Better Health of Kentucky)
• Juan Carlos Buling Afable, CRNA
• Alexander Yurievich Afanasyev, MD
• Affinicorp LLC

• Ambulatory Surgical Clinic/Center in Louisville, KY
• Providers in Louisville, KY by specialty
• Ambulatory Surgical Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.