Individual provider Active NPI

Izabela Antic, DO

  • Rheumatology Physician
  • Lexington, KY
National Provider Identifier
1295296945
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
05874 Issued in KY
Practice address
740 S Limestone Ste D200
Lexington, KY 40536-1760
Phone
(859) 323-6700
Fax
(859) 257-1331
NPI assigned
Mar 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 05874 KY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

740 S Limestone Ste D200
Lexington, KY 40536-1760

Mailing address

1737 Houndstooth GLN
Lexington, KY 40515-1301
Phone (859) 608-7036

Other practice location 1

250 Park St
Bowling Green, KY 42101-1760
Phone (270) 780-2693

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
University of Pikeville, Kentucky College of Osteopathic Med, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kentucky Medical Services Foundation, Inc 949 clinicians

Practice addresses (Care Compare)

740 S Limestone St
Lexington, KY 40508-1683
Phone (859) 257-8562

Hospital & facility affiliations

  • University of Kentucky Hospital Hospital, Lexington, KY, CCN 180067

Merit-based Incentive Payment System (MIPS)

Final score
85.77 of 100Reported as group
Quality
68.25
Promoting interoperability
100
Improvement activities
40
Cost
72.39

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
I20240805002875 KY Practitioner - Rheumatology 5799109633 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Medical Services Foundation, Inc CurrentSince Jul 16, 2024 Accepting new patients
University of Kentucky CurrentSince Jul 16, 2024 Accepting new patients

Locations

250 Park St
Bowling Green, KY 42101
Phone (270) 745-1000

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

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

NPI Registry JSON

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1295296945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1737 HOUNDSTOOTH GLN",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405151301",
            "telephone_number": "859-608-7036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE STE D200",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405361760",
            "telephone_number": "859-323-6700",
            "fax_number": "859-257-1331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Park St",
            "address_purpose": "LOCATION",
            "city": "Bowling Green",
            "state": "KY",
            "postal_code": "421011760",
            "country_code": "US",
            "telephone_number": "270-780-2693",
            "fax_number": "270-780-2691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANTIC",
        "first_name": "IZABELA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "KY",
            "license": "05874",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.