Individual provider Active NPI

Adam Alexander Didyk, DPM

  • Foot & Ankle Surgery Podiatrist
  • Louisville, KY
National Provider Identifier
1629286257
Registry record updated Dec 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
350 Issued in KY
Practice address
13105 Eastpoint Park Blvd
Louisville, KY 40223
Phone
(502) 426-4228
Fax
(502) 426-4420
NPI assigned
May 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 350 KY Primary

Addresses

Primary practice location

13105 Eastpoint Park Blvd
Louisville, KY 40223

Mailing address

13105 Eastpoint Park Blvd
Louisville, KY 40223
Phone (502) 426-4228

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091008000382 KY Practitioner - Podiatry 1153410311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13105 Eastpoint Park Blvd
Louisville, KY 40223-4164
Phone (502) 426-4228

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue579
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1837TXMDBehavioral Analyst
350KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
East End Foot & Ankle, PSC Foot & Ankle Surgery CurrentSince Aug 1, 2009 Accepting new patients
Dharmesh Bhakta, DPM, PA Foot & Ankle Surgery PastSince Sep 15, 2004 Accepting new patients

Locations

13105 Eastpoint Park Blvd
Louisville, KY 40223
Phone (502) 426-4228

Interoperability endpoints

  • Direct secure messaging: jcrabtree@eastendfootankle.direct.emds.com

Organizations & group practices 2

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": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513123200000",
    "number": "1629286257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13105 EASTPOINT PARK BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40223",
            "telephone_number": "502-426-4228",
            "fax_number": "502-426-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13105 EASTPOINT PARK BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40223",
            "telephone_number": "502-426-4228",
            "fax_number": "502-426-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIDYK",
        "first_name": "ADAM",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2017-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "KY",
            "license": "350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.