Individual provider Active NPI

Seneca C McGowan, PA-C

  • Physician Assistant
  • Louisville, KY
National Provider Identifier
1366952699
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA3102 Issued in KY
Practice address
2800 Breckenridge LN Ste 300
Louisville, KY 40220-1779
Phone
(502) 259-3341
Fax
(502) 259-3342
NPI assigned
Sep 29, 2017
Last updated
Jul 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA3102 KY Primary

Addresses

Primary practice location

2800 Breckenridge LN Ste 300
Louisville, KY 40220-1779

Mailing address

2800 Breckenridge LN Ste 300
Louisville, KY 40220-1779
Phone (502) 259-3341

Other identifiers 2

IdentifierTypeStateIssuer
300011189MedicaidIN
7100577820MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180129002437 IN Practitioner - Physician Assistant 1557621224 Reassigns benefits to 2 organizations
I20221212001955 KY Practitioner - Physician Assistant 1557621224 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
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)

3900 Kresge Way
Louisville, KY 40207-4681

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc Physician Assistant CurrentSince Apr 1, 2024 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Apr 1, 2024 Accepting new patients
Zilmed, Inc. PastSince Jan 1, 2015 Accepting new patients
Lowell Family Medical Care PC Past Accepting new patients

Locations

2800 Breckenridge Ln
Ste 300
Louisville, KY 40220
Phone (502) 259-3341

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BIGFCA

Organizations & group practices 7

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 1

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": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1366952699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 BRECKENRIDGE LN STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402201779",
            "telephone_number": "502-259-3341",
            "fax_number": "502-259-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 BRECKENRIDGE LN STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402201779",
            "telephone_number": "502-259-3341",
            "fax_number": "502-259-3342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOWAN",
        "first_name": "SENECA",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-29",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA3102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300011189",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100577820",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.