Individual provider Active NPI

Tao T Le, M.D.

  • Allergy Physician
  • Elizabethtown, KY
National Provider Identifier
1285615435
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
39835 Issued in KY
Practice address
914 N Dixie Ave
Suite 100
Elizabethtown, KY 42701-2520
Phone
(270) 765-6149
Fax
(270) 737-5235
NPI assigned
Nov 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X 39835 KY Primary

Addresses

Primary practice location

914 N Dixie Ave
Suite 100
Elizabethtown, KY 42701-2520

Mailing address

914 N Dixie Ave
Suite 100
Elizabethtown, KY 42701-2520
Phone (270) 765-6149

Other identifiers 4

IdentifierTypeStateIssuer
000000388373OtherKYANTHEM BCBS
2649647000OtherKYPASSPORT ADVANTAGE
64113772MedicaidKY
50009272OtherKYPASSPORT HEALTH PLAN

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
I20051021000156 KY Practitioner - Allergy/Immunology 4486611175 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39835KYMDAllergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spero Health of Kentucky, LLC CurrentSince May 13, 2022 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Sep 1, 2012 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Sep 1, 2012 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

914 N Dixie Ave
Ste 100
Elizabethtown, KY 42701
Phone (270) 266-2391

231 E Chestnut St
Louisville, KY 40202
Phone (502) 852-8500

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

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1285615435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 N DIXIE AVE",
            "address_2": "SUITE 100",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012520",
            "telephone_number": "270-765-6149",
            "fax_number": "270-737-5235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 N DIXIE AVE",
            "address_2": "SUITE 100",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012520",
            "telephone_number": "270-765-6149",
            "fax_number": "270-737-5235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "TAO",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "KY",
            "license": "39835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000388373",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "2649647000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64113772",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTH PLAN",
            "identifier": "50009272",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

Verify at the official NPI Registry.