NPIMap

Individual provider Active NPI

Matthew C Bartram

  • Physician Assistant
  • Louisville, KY
National Provider Identifier
1548669641
Registry record updated Dec 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
TC297 Issued in KY
Practice address
3 Audubon Plaza Dr
Suite 560
Louisville, KY 40217-1300
Phone
(502) 636-8004
Fax
(502) 636-8384
NPI assigned
Aug 14, 2014
Last updated
Dec 29, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2015

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 TC297 KY Primary

Addresses

Primary practice location

3 Audubon Plaza Dr
Suite 560
Louisville, KY 40217-1300

Mailing address

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

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
I20141105002241 KY Practitioner - Physician Assistant 1052533114 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
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

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

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
TC297KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates CurrentSince Sep 20, 2014 Accepting new patients
Community Medical Associates, Inc. CurrentSince Sep 20, 2014 Accepting new patients

Locations

3 Audubon Plaza Dr
Ste 560
Louisville, KY 40217
Phone (502) 636-8004

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

Interoperability endpoints

  • Direct secure messaging: mbartram69308@direct.nortonhealthcare.org

Organizations & group practices 3

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 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": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451347200000",
    "number": "1548669641",
    "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": "3 AUDUBON PLAZA DR",
            "address_2": "SUITE 560",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171300",
            "telephone_number": "502-636-8004",
            "fax_number": "502-636-8384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTRAM",
        "first_name": "MATTHEW",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-14",
        "last_updated": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.