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Individual provider Active NPI

Mercia Jeanne Duarte Bezerra Dibe Gondim, M.D.

  • Anatomic Pathology Physician
  • Louisville, KY
National Provider Identifier
1366841389
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
52236 Issued in KY
Practice address
550 S Jackson St
Louisville, KY 40202-1622
Phone
(502) 588-3600
NPI assigned
Aug 14, 2014
Last updated
Oct 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuropathology Physician 207ZN0500X 52236 KY
Anatomic Pathology Physician 207ZP0101X 52236 KY Primary

Addresses

Primary practice location

550 S Jackson St
Louisville, KY 40202-1622

Mailing address

PO Box 909
Louisville, KY 40201-0909
Phone (502) 852-1816

Other names 1

  • Dr. Mercia Jeanne Gondim Professional name

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
I20200217003340 KY Practitioner - Pathology 5698065787 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

550 S Jackson St
Louisville, KY 40202-1622
Phone (502) 852-5866

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
52236KYMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Oct 20, 2022 Accepting new patients
University of Louisville Physicians, Inc. Current Accepting new patients
Pediatric and Perinatal Pathology Associates PSC Anatomic Pathology CurrentSince Dec 11, 2019 Accepting new patients
University of Louisville Phyisicians, Inc. CurrentSince Oct 20, 2022 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

1169 Eastern Pkwy
Ste G71
Louisville, KY 40217
Phone (502) 456-6211

1941 Bishop Ln
Ste 1018
Louisville, KY 40218

231 E Chestnut St
#N12
Louisville, KY 40202

231 E Chestnut St
Ste 260
Louisville, KY 40202
Phone (502) 456-6217

550 S Jackson St
Louisville, KY 40202
Phone (502) 561-8686

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

Organizations & group practices 4

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1366841389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-852-1816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S JACKSON ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021622",
            "telephone_number": "502-588-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUARTE BEZERRA DIBE GONDIM",
        "first_name": "MERCIA",
        "middle_name": "JEANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZN0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Neuropathology",
            "state": "KY",
            "license": "52236",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "KY",
            "license": "52236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MERCIA",
            "last_name": "GONDIM",
            "middle_name": "JEANNE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.