NPIMap

Individual provider Active NPI

Amit J Dwivedi, MD

  • Vascular Surgery Physician
  • Louisville, KY
National Provider Identifier
1265541874
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
40138 Issued in KY
Practice address
401 E Chestnut St
Suite 710
Louisville, KY 40202
Phone
(502) 583-8303
Fax
(502) 584-0302
NPI assigned
Aug 29, 2006
Last updated
Jun 27, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 40138 KY
Vascular Surgery Physician 2086S0129X 40138 KY Primary

Addresses

Primary practice location

401 E Chestnut St
Suite 710
Louisville, KY 40202

Mailing address

PO Box 909
Louisville, KY 40201-0909
Phone (502) 588-0328

Other identifiers 3

IdentifierTypeStateIssuer
50012628OtherKYPASSPORT
200855340MedicaidIN
64123706MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070216000546 KY Practitioner - General Surgery 9133221484 Reassigns benefits to 1 organization
I20110817000600 IN Practitioner - General SurgeryPractitioner - Vascular Surgery 9133221484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Vascular Surgery
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SN Kentuckiana Rehab, LLCGroup PAC ID 1254671464, shared by 19 NPIs, 339 clinicians

Practice addresses (Care Compare)

12613 Taylorsville Rd
Louisville, KY 40299-5496
Phone (502) 267-1480

401 E Chestnut St
Suite 710
Louisville, KY 40202-5707
Phone 50258383032

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)49
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40138KYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Mar 1, 2012 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Mar 1, 2012 Accepting new patients
University of Louisville Physicians, Inc Current Accepting new patients
University of Louisville Physicians, Inc. Surgery Current Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Mar 1, 2012 Accepting new patients
University of Louisville Physicians, Inc. Past Accepting new patients
Uofl Health-Louisville Inc Past Accepting new patients
University of Louisville Physicians Inc. Past Accepting new patients
Norton Hospitals, Inc Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

2051 Clevidence Blvd
Clarksville, IN 47129
Phone (812) 280-6650

401 E Chestnut St
Unit 710
Louisville, KY 40202
Phone 50258383031332

4950 Norton Healthcare Blvd
Louisville, KY 40241
Phone (502) 425-5556

550 S Jackson St
Louisville, KY 40202
Phone (502) 561-8686

550 S Jackson St
Fl 3
Louisville, KY 40202
Phone (502) 561-8850

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

Organizations & group practices 9

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 39

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1265541874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-588-0328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E CHESTNUT ST",
            "address_2": "SUITE 710",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40202",
            "telephone_number": "502-583-8303",
            "fax_number": "502-584-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWIVEDI",
        "first_name": "AMIT",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "40138",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "KY",
            "license": "40138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50012628",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200855340",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64123706",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.