NPIMap

Individual provider Active NPI

Renu M. Mehta, M.D.

  • Family Medicine Physician
  • Fairdale, KY
National Provider Identifier
1306893375
Registry record updated Apr 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35332 Issued in KY
Practice address
900 Fairdale Rd
Fairdale, KY 40118-9731
Phone
(502) 366-8778
Fax
(502) 366-9163
NPI assigned
May 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35332 KY Primary

Addresses

Primary practice location

900 Fairdale Rd
Fairdale, KY 40118-9731

Mailing address

6801 Dixie Hwy
Ste 130
Louisville, KY 40258-3913
Phone (502) 366-8778

Other identifiers 1

IdentifierTypeStateIssuer
64009764MedicaidKY

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
I20081203000353 KY Practitioner - Family Practice 6103987664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

215 Central Ave
Suite 100
Louisville, KY 40208-1450
Phone (502) 588-8720

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35332KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. Family Medicine Current Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Oct 11, 2019 Accepting new patients

Locations

900 Fairdale Rd
Fairdale, KY 40118
Phone (502) 366-8778

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

215 Central Ave
Ste 100
Louisville, KY 40208
Phone (502) 588-8720

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

Interoperability endpoints

  • Direct secure messaging: rmehta13857@uoflhealth-dm.org

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 38

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

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365033600000",
    "number": "1306893375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 DIXIE HWY",
            "address_2": "STE 130",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402583913",
            "telephone_number": "502-366-8778",
            "fax_number": "502-366-9163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 FAIRDALE RD",
            "city": "FAIRDALE",
            "state": "KY",
            "postal_code": "401189731",
            "telephone_number": "502-366-8778",
            "fax_number": "502-366-9163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "RENU",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2013-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "35332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64009764",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairdale, KY

Sources for this page

Verify at the official NPI Registry.