Individual provider Active NPI

Angela L Mahan, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Louisville, KY
National Provider Identifier
1275670556
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
44595 Issued in KY
Practice address
4003 Kresge Way Ste 224
Louisville, KY 40207
Phone
(502) 895-2295
Fax
(502) 895-2296
NPI assigned
Jan 30, 2007
Last updated
Dec 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 44595 KY Primary

Addresses

Primary practice location

4003 Kresge Way Ste 224
Louisville, KY 40207

Mailing address

2700 Stanley Gault Pkwy Ste 129
Louisville, KY 40223-5176
Phone (502) 253-4900

Other practice location 1

740 South Limestone Room A301
Lexington, KY 40536
Phone (859) 323-6494

Other identifiers 1

IdentifierTypeStateIssuer
7100243450MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amahan24753@bhkydirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130820001010 KY Practitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 5092957183 Reassigns benefits to 3 organizations
I20180718003929 IN Practitioner - Thoracic Surgery 5092957183 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
University of Louisville School of Medicine, 2006
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)

1373 E State Rd
Madison, IN 47250-7328
Phone (812) 801-0810

1850 State St
New Albany, IN 47150-4990
Phone (812) 949-5550

1919 State St
Suite 310
New Albany, IN 47150-6806
Phone (812) 542-4604

521 Robinbrooke Blvd
Elizabethtown, KY 42701-5904
Phone (270) 706-1535

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
Upper gastrointestinal (GI) endoscopy for acid reflux49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44595KYMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Dec 1, 2020 Accepting new patients
Kentucky Medical Services Foundation, Inc CurrentSince Jul 1, 2013 Accepting new patients
Baptist Health Medical Group Inc Current Accepting new patients
Baptist Health Medical Group Inc Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Aug 1, 2018 Accepting new patients
Baptist Health Medical Group Inc Current Accepting new patients
Baptist Health Medical Group Inc CurrentSince Aug 1, 2018 Accepting new patients
Baptist Healthcare System Inc. Past Accepting new patients
University of Kentucky Past Accepting new patients

Locations

1373 N State Road 62
Madison, IN 47250
Phone (812) 801-0196

2125 State St
Ste 3
New Albany, IN 47150
Phone (812) 949-5575

521 Robinbrooke Blvd
Elizabethtown, KY 42701
Phone (270) 706-1535

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

2700 Stanley Gault Pkwy
Ste 129
Louisville, KY 40223
Phone (502) 253-4900

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

4003 Kresge Way
Ste 224
Louisville, KY 40207
Phone (502) 894-0064

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

Interoperability endpoints

  • Direct secure messaging: amahan24753@bhkydirect.com

Organizations & group practices 8

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 4

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1275670556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 STANLEY GAULT PKWY STE 129",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235176",
            "telephone_number": "502-253-4900",
            "fax_number": "502-489-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4003 KRESGE WAY STE 224",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40207",
            "telephone_number": "502-895-2295",
            "fax_number": "502-895-2296"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "740 South Limestone Room A301",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "40536",
            "country_code": "US",
            "telephone_number": "859-323-6494",
            "fax_number": "859-257-4682",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHAN",
        "first_name": "ANGELA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "KY",
            "license": "44595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100243450",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amahan24753@bhkydirect.com",
            "affiliation": "N",
            "address_1": "2125 State St Ste 3",
            "city": "New Albany",
            "state": "IN",
            "country_code": "US",
            "postal_code": "471504972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.