NPIMap

Organization Active NPI

Surgical Care Associates PSC

  • Vascular Surgery Physician
  • Louisville, KY
National Provider Identifier
1598745283
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
SURGICAL CARE ASSOCIATES PSC
Practice address
4003 Kresge Way
Suite 300
Louisville, KY 40207-4652
Phone
(502) 897-5139
Fax
(502) 896-6218
NPI assigned
Jan 19, 2006
Last updated
Nov 27, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2019

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

Authorized official

Name
Ms. Marcia L Hughes
Title
Practice Manager
Phone
(502) 897-5139

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X NU Primary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU

Addresses

Primary practice location

4003 Kresge Way
Suite 300
Louisville, KY 40207-4652

Mailing address

4003 Kresge Way
Suite 300
Louisville, KY 40207-4652
Phone (502) 897-5139

Other practice location 1

1919 State St Ste 200
New Albany, IN 47150-6804
Phone (502) 897-5139

Other identifiers 4

IdentifierTypeStateIssuer
65900516MedicaidKY
7100623120MedicaidKY
300020930MedicaidIN
7100628950MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031208000303 KY Part B Supplier - Clinic/Group Practice 8729984232 Receives reassigned benefits from 10 practitioners
Practice locations: Louisville, KY

National Provider Directory

National Provider Directory

Locations

4003 Kresge Way
Ste 100
Louisville, KY 40207
Phone (502) 897-5139

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574812800000",
    "number": "1598745283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4003 KRESGE WAY",
            "address_2": "SUITE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074652",
            "telephone_number": "502-897-5139",
            "fax_number": "502-896-6218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4003 KRESGE WAY",
            "address_2": "SUITE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074652",
            "telephone_number": "502-897-5139",
            "fax_number": "502-896-6218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1919 State St Ste 200",
            "address_purpose": "LOCATION",
            "city": "New Albany",
            "state": "IN",
            "postal_code": "471506804",
            "country_code": "US",
            "telephone_number": "502-897-5139",
            "fax_number": "502-896-6218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SURGICAL CARE ASSOCIATES PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-19",
        "last_updated": "2019-11-27",
        "status": "A",
        "authorized_official_last_name": "HUGHES",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "502-897-5139",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65900516",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100623120",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300020930",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100628950",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.