Individual provider Active NPI

Marcelo Enrique Venegas, A.P.R.N.

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1467891382
Registry record updated Apr 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3008115 Issued in KY
Practice address
5100 Outer Loop
Louisville, KY 40219-3023
Phone
(502) 968-6226
Fax
(502) 966-5562
NPI assigned
Jun 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3008115 KY Primary

Addresses

Primary practice location

5100 Outer Loop
Louisville, KY 40219-3023

Mailing address

100 E Liberty St Ste 800
Louisville, KY 40202-1428
Phone (502) 540-3339

Other identifiers 1

IdentifierTypeStateIssuer
7100247090MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130828001050 KY Practitioner - Nurse Practitioner 6709029341 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc CurrentSince Jun 26, 2018 Accepting new patients
Internal Medicine Consultants, PLLC Family CurrentSince Jul 13, 2013 Accepting new patients
University of Louisville Physicians, Inc. Current Accepting new patients
Internal Medicine Consultants, PLLC PastSince Jul 13, 2013 Accepting new patients
Komg-Louisville Region Inc. Past Accepting new patients

Locations

Dept 8085
Carol Stream, IL 60122

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

1941 Bishop Ln
Ste 900
Louisville, KY 40218
Phone (502) 588-2500

234 E Gray St
Ste 670
Louisville, KY 40202
Phone (502) 629-3477

5100 Outer Loop
Louisville, KY 40219
Phone (502) 968-6226

Interoperability endpoints

  • Direct secure messaging: marcelo.venegas@49428401684484.direct.elationemr.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1467891382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LIBERTY ST STE 800",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021428",
            "telephone_number": "502-540-3339",
            "fax_number": "502-540-3393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 OUTER LOOP",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402193023",
            "telephone_number": "502-968-6226",
            "fax_number": "502-966-5562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENEGAS",
        "first_name": "MARCELO",
        "middle_name": "ENRIQUE",
        "credential": "A.P.R.N.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-25",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3008115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100247090",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.