NPIMap

Individual provider Active NPI

Derrick Edward Tobias, M.D

  • Internal Medicine Physician
  • Louisville, KY
National Provider Identifier
1386617470
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
39298 Issued in KY
Practice address
200 E Chestnut St Ste 303
Louisville, KY 40202-1831
Phone
(502) 629-5552
Fax
(502) 629-3132
NPI assigned
Feb 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 39298 KY Primary

Addresses

Primary practice location

200 E Chestnut St Ste 303
Louisville, KY 40202-1831

Mailing address

PO Box 766351
Chicago, IL 60677-6351
Phone (502) 588-9490

Other identifiers 9

IdentifierTypeStateIssuer
000028412OOtherKYHUMANA - NIS
0752823OtherKYCIGNA - NIS
200803120MedicaidIN
085911OtherKYSIHO - NIS
P00460518OtherKYRR-MCR-KY - NIS
000000515641OtherANTHEM - NINPTSPEC
2648495000OtherPAD - NINPTSPEC
50014705OtherPASSPORT - NINPTSPEC
64105570MedicaidKY

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
I20050628000175 KY Practitioner - Internal Medicine 7911942149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

1 Audubon Plaza Dr
Louisville, KY 40217-1318
Phone (502) 636-7225

4960 Norton Healthcare Blvd
Louisville, KY 40241-2831
Phone (502) 446-8125

825 Barret Ave
Louisville, KY 40204-1743
Phone (502) 272-5165

Hospital & facility affiliations

  • Norton Hospitals, Inc Hospital, Louisville, KY, CCN 180088

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39298KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. CurrentSince Aug 1, 2009 Accepting new patients
Community Medical Associates, Inc. Internal Medicine CurrentSince Aug 1, 2009 Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
Norton Hospitals, Inc Past Accepting new patients
Hospital Internal Medicine Associates, PLLC Internal Medicine Past Accepting new patients
Inpatient Care Specialist, LLC Past Accepting new patients

Locations

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

200 E Chestnut St
Ste 303
Louisville, KY 40202
Phone (502) 629-5552

Interoperability endpoints

  • Direct secure messaging: dtobias6205@direct.nortonhealthcare.org

Organizations & group practices 6

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1386617470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 766351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E CHESTNUT ST STE 303",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021831",
            "telephone_number": "502-629-5552",
            "fax_number": "502-629-3132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIAS",
        "first_name": "DERRICK",
        "middle_name": "EDWARD",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "39298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA - NIS",
            "identifier": "000028412O",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA - NIS",
            "identifier": "0752823",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200803120",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO - NIS",
            "identifier": "085911",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR-MCR-KY - NIS",
            "identifier": "P00460518",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM - NINPTSPEC",
            "identifier": "000000515641",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PAD - NINPTSPEC",
            "identifier": "2648495000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT - NINPTSPEC",
            "identifier": "50014705",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64105570",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.