Individual provider Active NPI

Nitin N Wadhwa, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Louisville, KY
National Provider Identifier
1609095520
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
39290 Issued in KY
Practice address
4123 Dutchmans LN Ste 301
Louisville, KY 40207-4721
Phone
(502) 896-2500
Fax
(502) 896-2527
NPI assigned
Apr 25, 2007
Last updated
Jan 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 39290 KY
Neonatal-Perinatal Medicine Physician 2080N0001X 39290 KY Primary

Addresses

Primary practice location

4123 Dutchmans LN Ste 301
Louisville, KY 40207-4721

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 899-9490

Other identifiers 5

IdentifierTypeStateIssuer
201160960MedicaidIN
50049164OtherKYPASSPORT - KCNS
000000805260OtherKYANTHEM -KCNS
145059OtherKYSIHO - KCNS
7000033820MedicaidKY

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nwadhwa54150@direct.nortonhealthcare.org
FHIR URL https://epicsoap.nortonhealthcare.org/

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130409000146 KY Practitioner - Pediatric Medicine 5698911097 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39290KYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Children's Medical Group, LLC CurrentSince Mar 1, 2020 Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
Community Medical Associates, Inc. Pediatrics CurrentSince Feb 25, 2013 Accepting new patients
Norton Children's Medical Group, LLC Current Accepting new patients
Norton Children's Medical Group, LLC CurrentSince Mar 1, 2020 Accepting new patients
Community Medical Associates, Inc. CurrentSince Feb 25, 2013 Accepting new patients
Baptist Healthcare System Inc. Past Accepting new patients
Norton Hospitals, Inc Past Accepting new patients

Locations

4123 Dutchmans Ln
Ste 301
Louisville, KY 40207
Phone (502) 896-2500

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

601 S Floyd St
Ste 700
Louisville, KY 40202
Phone (502) 629-7181

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

Interoperability endpoints

  • Direct secure messaging: nwadhwa54150@direct.nortonhealthcare.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1609095520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-899-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 DUTCHMANS LN STE 301",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074721",
            "telephone_number": "502-896-2500",
            "fax_number": "502-896-2527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADHWA",
        "first_name": "NITIN",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "39290",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "KY",
            "license": "39290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201160960",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT - KCNS",
            "identifier": "50049164",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM -KCNS",
            "identifier": "000000805260",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO - KCNS",
            "identifier": "145059",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7000033820",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nwadhwa54150@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "4123 Dutchmans Ln Ste 301",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402074721",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/",
            "affiliation": "N",
            "address_1": "4123 Dutchmans Ln Ste 301",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402074721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.