Individual provider Active NPI

Lily Nowakowski

  • Physician Assistant
  • Louisville, KY
National Provider Identifier
1528823648
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
529 S Jackson St FL 3
Louisville, KY 40202-3229
Phone
(502) 561-7220
NPI assigned
Feb 19, 2024
Last updated
Nov 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 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 NU Primary

Addresses

Primary practice location

529 S Jackson St FL 3
Louisville, KY 40202-3229

Mailing address

529 S Jackson St FL 3
Louisville, KY 40202-3229
Phone (502) 561-7220

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
I20241127000698 KY Practitioner - Physician Assistant 3870028806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1903 W Hebron LN
Shepherdsville, KY 40165-7425
Phone (502) 852-5341

530 S Jackson St
Louisville, KY 40202-1675

571 S Floyd St
Louisville, KY 40202-3818
Phone (502) 629-2398

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TC095KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Dec 1, 2024 Accepting new patients
University of Louisville Phyisicians, Inc. Physician Assistant CurrentSince Dec 1, 2024 Accepting new patients
University Obstetrical and Gynecological Associates, PSC PastSince Nov 17, 2024 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

529 S Jackson St
Fl 3
Louisville, KY 40202
Phone (502) 561-7220

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

Interoperability endpoints

  • Direct secure messaging: lnowakowski55535@uoflhealth-dm.org

Organizations & group practices 4

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": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1528823648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 S JACKSON ST FL 3",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402023229",
            "telephone_number": "502-561-7220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 S JACKSON ST FL 3",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402023229",
            "telephone_number": "502-561-7220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWAKOWSKI",
        "first_name": "LILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.