Individual provider Active NPI

Mais Alwan, DO

  • Internal Medicine Physician
  • Lexington, KY
National Provider Identifier
1306586623
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
TP279 Issued in KY
Practice address
900 S Limestone CTW 304
Lexington, KY 40536-0001
Phone
(859) 323-2834
Fax
(859) 257-2605
NPI assigned
Apr 1, 2022
Last updated
May 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X TP279 KY Primary

Addresses

Primary practice location

900 S Limestone CTW 304
Lexington, KY 40536-0001

Mailing address

1901 Campus PL
Louisville, KY 40299-2308
Phone (502) 253-4924

Other practice location 1

2800 Breckenridge Ln Ste 200
Louisville, KY 40220-1771
Phone (502) 893-7462

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
I20250528001606 KY Practitioner - Internal Medicine 3870948979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

2800 Breckenridge LN
Suite 200
Louisville, KY 40220-1402
Phone (502) 893-7462

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TP279KYMDSurgical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc Internal Medicine CurrentSince May 13, 2025 Accepting new patients
Baptist Health Medical Group Inc CurrentSince May 13, 2025 Accepting new patients

Locations

1901 Campus Pl
Louisville, KY 40299
Phone (502) 253-4911

2800 Breckenridge Ln
Ste 200
Louisville, KY 40220
Phone (502) 893-7462

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1648771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1306586623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 CAMPUS PL",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992308",
            "telephone_number": "502-253-4924",
            "fax_number": "502-489-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S LIMESTONE CTW 304",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360001",
            "telephone_number": "859-323-2834",
            "fax_number": "859-257-2605"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 Breckenridge Ln Ste 200",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402201771",
            "country_code": "US",
            "telephone_number": "502-893-7462",
            "fax_number": "502-212-7551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALWAN",
        "first_name": "MAIS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-01",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "TP279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.