NPIMap

Individual provider Active NPI

Abdolreza Agahtehrani, M.D.

  • Interventional Cardiology Physician
  • Louisville, KY
National Provider Identifier
1437267663
Registry record updated Sep 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
43033 Issued in KY
Practice address
6420 Dutchmans Pkwy
Ste 200
Louisville, KY 40205-3372
Phone
(502) 891-8300
NPI assigned
Aug 28, 2006
Last updated
Sep 17, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 43033 KY Primary

Addresses

Primary practice location

6420 Dutchmans Pkwy
Ste 200
Louisville, KY 40205-3372

Mailing address

PO Box 950202
Louisville, KY 40295-0202
Phone (502) 588-9490

Other identifiers 9

IdentifierTypeStateIssuer
000000635481OtherANTHEM
7100045440MedicaidKY
50025829OtherPASSPORT
201044560MedicaidIN
3737980000OtherPASSPORT ADVANTAGE
50031143OtherKYPASSPORT & PASSPORT ADVTG - NCVA
000000693017OtherKYANTHEM - NCVA
P00893011OtherKYRAILROAD MEDICARE - NCVA
000057058WOtherKYHUMANA - NCVA

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
I20091021000645 KY Practitioner - Cardiovascular Disease (Cardiology) 4587660550 Reassigns benefits to 1 organization
I20161202001149 IN Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 4587660550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Temple University School of Medicine, 1998
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

150 Franfort Rd
Shelbyville, KY 40065-7401

200 E Chestnut St
Louisville, KY 40202-1831
Phone (502) 893-1270

2051 Clevidence Blvd
Suite a
Clarksville, IN 47129-2278
Phone (812) 282-1720

2410 Ring Rd
Suite 500
Elizabethtown, KY 42701-7991
Phone (502) 891-8300

4001 Dutchmans LN
Louisville, KY 40207-4714
Phone (502) 893-1270

4420 Dixie Hwy
Suite 118
Louisville, KY 40216-2991
Phone (502) 447-3448

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

6420 Dutchmans Pkwy
Suite 200
Louisville, KY 40205-3373
Phone (502) 891-8300

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

Hospital & facility affiliations

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting47
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Current Accepting new patients
Community Medical Associates, Inc. Interventional Cardiology CurrentSince Jan 1, 2011 Accepting new patients
Trustees Columbia University City Ny Center Interventional Vascular TH Interventional Cardiology Past Accepting new patients
St. Mary's Himg, LLC Interventional Cardiology Past Accepting new patients
Trustees of Columbia University in the City of New York Past Accepting new patients
Ultimate Health Services Inc Past Accepting new patients
Community Medical Associates, Inc. Past Accepting new patients

Locations

2051 Clevidence Blvd
Ste A
Clarksville, IN 47129
Phone (812) 280-1720

6420 Dutchmans Pkwy
Ste 200
Louisville, KY 40205
Phone (502) 891-8333

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

Interoperability endpoints

  • Direct secure messaging: aagahtehrani12550@direct.nortonhealthcare.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 8

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 37

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

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410912000000",
    "number": "1437267663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950202",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402950202",
            "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": "6420 DUTCHMANS PKWY",
            "address_2": "STE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402053372",
            "telephone_number": "502-891-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGAHTEHRANI",
        "first_name": "ABDOLREZA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2014-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "KY",
            "license": "43033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000635481",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100045440",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50025829",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201044560",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "3737980000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT & PASSPORT ADVTG - NCVA",
            "identifier": "50031143",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM - NCVA",
            "identifier": "000000693017",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE - NCVA",
            "identifier": "P00893011",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA - NCVA",
            "identifier": "000057058W",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.