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Organization Active NPI

Ellis & Badenhausen Orthopaedics, PSC

  • Orthopaedic Surgery Physician
  • Louisville, KY
National Provider Identifier
1346356284
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
079020 Issued in KY
Legal business name
ELLIS & BADENHAUSEN ORTHOPAEDICS, PSC
Practice address
13151 Magisterial Dr
Suite 200
Louisville, KY 40223-4103
Phone
(502) 587-1236
Fax
(502) 587-0126
NPI assigned
Aug 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Authorized official

Name
Tashana M Preston, CPC
Title
Billing Director
Phone
(502) 587-1236

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X 079020 KY Primary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X 079020 KY
Durable Medical Equipment & Medical Supplies 332B00000X 079020 KY
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

13151 Magisterial Dr
Suite 200
Louisville, KY 40223-4103

Mailing address

PO Box 32486
Louisville, KY 40232-2486
Phone (502) 587-1236

Other identifiers 1

IdentifierTypeStateIssuer
079020OtherKYSTATE ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040415000605 KY Part B Supplier - Clinic/Group Practice 9032104559 Receives reassigned benefits from 37 practitioners
5 other NPIs on this enrollment
Practice locations: Louisville, KY; Shepherdsville, KY
O20110722000190 IN Part B Supplier - Clinic/Group Practice 9032104559 Receives reassigned benefits from 17 practitioners
2 other NPIs on this enrollment
Practice locations: New Albany, IN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

3605 Northgate Ct
Ste 212
New Albany, IN 47150

4123 Dutchmans Ln
Ste 100
Louisville, KY 40207
Phone (502) 636-4905

5120 Dixie Hwy
Ste 100
Louisville, KY 40216

181 Highway 44 E
Ste 4
Shepherdsvlle, KY 40165
Phone (502) 779-3002

Practitioners & affiliated clinicians

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740614400000",
    "number": "1346356284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32486",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402322486",
            "telephone_number": "502-587-1236",
            "fax_number": "502-587-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13151 MAGISTERIAL DR",
            "address_2": "SUITE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402234103",
            "telephone_number": "502-587-1236",
            "fax_number": "502-587-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIS & BADENHAUSEN ORTHOPAEDICS, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A",
        "authorized_official_last_name": "PRESTON",
        "authorized_official_first_name": "TASHANA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BILLING DIRECTOR",
        "authorized_official_telephone_number": "502-587-1236",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "KY",
            "license": "079020",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "KY",
            "license": "079020",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "KY",
            "license": "079020",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE ID",
            "identifier": "079020",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.