NPIMap

Individual provider Active NPI

Mary T Self, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Louisville, KY
National Provider Identifier
1306882170
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
24710 Issued in KY
Practice address
6400 Dutchmans Pkwy Ste 345
Louisville, KY 40205-3370
Phone
(502) 587-6010
Fax
(502) 587-1314
NPI assigned
Jun 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 24710 KY Primary

Addresses

Primary practice location

6400 Dutchmans Pkwy Ste 345
Louisville, KY 40205-3370

Mailing address

100 E Liberty St
Suite 800
Louisville, KY 40202-1434
Phone (502) 587-6010

Other identifiers 1

IdentifierTypeStateIssuer
64247109MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100826001150 KY Practitioner - Endocrinology 8921136102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
University of Louisville School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

201 Abraham Flexner Way
Suite 1200
Louisville, KY 40202-3481
Phone (502) 583-8383

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24710KYMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Nov 1, 2019 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Nov 1, 2019 Accepting new patients
University of Louisville Physicians, Inc. Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

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

201 Abraham Flexner Way
Ste 1200
Louisville, KY 40202
Phone (502) 583-8383

6400 Dutchmans Pkwy
Ste 345
Louisville, KY 40205
Phone (502) 315-1450

5100 Outer Loop
Louisville, KY 40219
Phone (502) 968-6226

Interoperability endpoints

  • Direct secure messaging: mself13998@uoflhealth-dm.org

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.

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": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1306882170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LIBERTY ST",
            "address_2": "SUITE 800",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021434",
            "telephone_number": "502-587-6010",
            "fax_number": "502-587-1314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 DUTCHMANS PKWY STE 345",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402053370",
            "telephone_number": "502-587-6010",
            "fax_number": "502-587-1314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELF",
        "first_name": "MARY",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "KY",
            "license": "24710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64247109",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.