NPIMap

Individual provider Active NPI

Michael Ames Punnett, MD

  • Family Medicine Physician
  • Crestwood, KY
National Provider Identifier
1619968013
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37781 Issued in KY
Practice address
6580 Kenwood Crossing Rd
Crestwood, KY 40014-7614
Phone
(502) 243-3161
Fax
(502) 243-3164
NPI assigned
Nov 3, 2005
Last updated
Dec 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01062436A IN
Hospitalist Physician 208M00000X 37781 KY
Family Medicine Physician 207Q00000X 37781 KY Primary

Addresses

Primary practice location

6580 Kenwood Crossing Rd
Crestwood, KY 40014-7614

Mailing address

PO Box 950248
Louisville, KY 40295-0248
Phone (502) 489-5730

Other identifiers 3

IdentifierTypeStateIssuer
64069289MedicaidKY
11199652OtherCAOH
200857410AMedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mpunnett8383@bhkydirect.com

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
I20121127000563 KY Practitioner - Family Practice 7810092376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Louisville School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

1025 New Moody LN
La Grange, KY 40031-9154
Phone (502) 222-3255

3900 Kresge Way
Louisville, KY 40207-4681

6580 Kenwood Crossing Rd
Crestwood, KY 40014-7614
Phone (502) 241-1660

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01062436AINMDFamily Medicine Physician
37781KYMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc Hospitalist CurrentSince Oct 22, 2012 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Oct 22, 2012 Accepting new patients
Baptist Health Medical Group Inc Past Accepting new patients

Locations

6580 Kenwood Crossing Rd
Crestwood, KY 40014
Phone (502) 241-1660

13117 Eastpoint Park Blvd
Ste C
Louisville, KY 40223
Phone (502) 254-0907

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

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 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1619968013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950248",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402950248",
            "telephone_number": "502-489-5730",
            "fax_number": "502-489-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6580 KENWOOD CROSSING RD",
            "city": "CRESTWOOD",
            "state": "KY",
            "postal_code": "400147614",
            "telephone_number": "502-243-3161",
            "fax_number": "502-243-3164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNNETT",
        "first_name": "MICHAEL",
        "middle_name": "AMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01062436A",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KY",
            "license": "37781",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "37781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64069289",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAOH",
            "identifier": "11199652",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200857410A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpunnett8383@bhkydirect.com",
            "affiliation": "N",
            "address_1": "6580 Kenwood Crossing Rd",
            "city": "Crestwood",
            "state": "KY",
            "country_code": "US",
            "postal_code": "400147614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crestwood, KY

Sources for this page

Verify at the official NPI Registry.