NPIMap

Individual provider Active NPI

Crystal Hamilton McMahan, M.D.

  • Radiation Oncology Physician
  • Louisville, KY
National Provider Identifier
1396969200
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
42203 Issued in KY
Practice address
4003 Kresge Way
Ste 115
Louisville, KY 40207-4652
Phone
(502) 897-8163
Fax
(502) 897-8052
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 42203 KY Primary

Addresses

Primary practice location

4003 Kresge Way
Ste 115
Louisville, KY 40207-4652

Mailing address

PO Box 950248
Louisville, KY 40295-0248
Phone (502) 489-5730

Other identifiers 3

IdentifierTypeStateIssuer
50027952OtherKYPASSPORT
7100059430MedicaidKY
000000651185OtherKYANTHEM

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cmcmahan7917@bhkydirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20081104000786 KY Practitioner - Radiation Oncology 7416016548 Reassigns benefits to 1 organization
I20170220002142 IN Practitioner - Radiation Oncology 7416016548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Louisville School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

4003 Kresge Way
Suite 115
Louisville, KY 40207-5603
Phone (502) 897-8163

Hospital & facility affiliations

  • Baptist Health Louisville Hospital, Louisville, KY, CCN 180130
  • Baptist Health Lagrange Hospital, La Grange, KY, CCN 180138
  • Baptist Health Hardin Hospital, Elizabethtown, KY, CCN 180012
  • Norton Hospitals, Inc Hospital, Louisville, KY, CCN 180088

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42203KYMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince May 21, 2012 Accepting new patients
Baptist Health Medical Group Inc Radiation Oncology CurrentSince May 21, 2012 Accepting new patients
Baptist Health Medical Group Inc Current Accepting new patients
Baptist Health Medical Group Inc Past Accepting new patients
Baptist Medical Associates, Inc. Past Accepting new patients

Locations

1373 N State Road 62
Madison, IN 47250
Phone (812) 801-0196

13117 Eastpoint Park Blvd
Ste C
Louisville, KY 40223
Phone (502) 254-0907

4003 Kresge Way
Ste 115
Louisville, KY 40207
Phone (502) 897-8163

2700 Stanley Gault Pkwy
Ste 129
Louisville, KY 40223
Phone (502) 253-4900

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

Organizations & group practices 5

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1396969200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950248",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402950248",
            "telephone_number": "502-489-5730",
            "fax_number": "502-489-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4003 KRESGE WAY",
            "address_2": "STE 115",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074652",
            "telephone_number": "502-897-8163",
            "fax_number": "502-897-8052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHAN",
        "first_name": "CRYSTAL",
        "middle_name": "HAMILTON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "KY",
            "license": "42203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50027952",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100059430",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000651185",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmcmahan7917@bhkydirect.com",
            "affiliation": "N",
            "address_1": "4003 Kresge Way",
            "address_2": "Ste 115",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402074652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.