Individual provider Active NPI

Callie Leeanne Rzasa, M.D.

  • Pediatric Cardiology Physician
  • Lexington, KY
National Provider Identifier
1629323746
Registry record updated Dec 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
49619 Issued in KY
Practice address
138 Leader Ave
RM 252
Lexington, KY 40506-3215
Phone
(859) 323-5962
NPI assigned
Jul 14, 2012
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Cardiovascular Disease (Cardiology)
Education
University of Michigan Medical School, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kentucky Medical Services Foundation, Inc 949 clinicians

Practice addresses (Care Compare)

100 Greatstone PT
Lexington, KY 40504-3274
Phone (859) 257-9800

101 Sanders-Brown BLDG
Lexington, KY 40536-0001
Phone (859) 257-1412

2400 Greatstone PT
Lexington, KY 40504-3274
Phone (859) 323-7426

800 Rose St
Lexington, KY 40536-0001
Phone (859) 323-5000

830 S Limestone
Lexington, KY 40536-0001
Phone (859) 323-0303

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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20160922002009 KY Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 7719274463 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A118429CAMDPediatric Cardiology Physician
49619KYMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Medical Services Foundation, Inc CurrentSince Aug 15, 2016 Accepting new patients

Locations

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

Interoperability endpoints

  • Direct secure messaging: crzasa22015@ukhcdirect.org

Specialties & licenses 4

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X TP234 KY
Pediatric Cardiology Physician 2080P0202X A118429 CA
Student in an Organized Health Care Education/Training Program 390200000X A118429 CA
Pediatric Cardiology Physician 2080P0202X 49619 KY Primary

Addresses

NPPES NPI Registry

Primary practice location

138 Leader Ave
RM 252
Lexington, KY 40506-3215

Mailing address

138 Leader Ave
RM 252
Lexington, KY 40506-3215
Phone (859) 323-5962

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 19, 2017.

{
    "created_epoch": "1342224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513641600000",
    "number": "1629323746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 LEADER AVE",
            "address_2": "RM 252",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405063215",
            "telephone_number": "859-323-5962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 LEADER AVE",
            "address_2": "RM 252",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405063215",
            "telephone_number": "859-323-5962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RZASA",
        "first_name": "CALLIE",
        "middle_name": "LEEANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-14",
        "last_updated": "2017-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "KY",
            "license": "TP234",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "A118429",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "A118429",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "KY",
            "license": "49619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.