Individual provider Active NPI

Meredith Mader Tatarzycki

  • Certified Registered Nurse Anesthetist
  • Louisville, KY
National Provider Identifier
1669968111
Registry record updated Nov 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3012692 Issued in KY
Practice address
530 S Jackson St
Louisville, KY 40202-1675
Phone
(502) 852-5851
NPI assigned
Jul 9, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 209900 TN
Certified Registered Nurse Anesthetist 367500000X 3012692 KY Primary

Addresses

Primary practice location

530 S Jackson St
Louisville, KY 40202-1675

Mailing address

PO Box 909
Louisville, KY 40201-0909
Phone (502) 588-0330

Other identifiers 4

IdentifierTypeStateIssuer
3012692OtherKYLICENSE
300020101MedicaidIN
7100557470MedicaidKY
K235880OtherKYMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181025001871 KY Practitioner - Nurse Practitioner 5991058653 Reassigns benefits to 1 organization
I20190814001031 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 5991058653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Louisville Physicians IncGroup PAC ID 3476725599, 1,438 clinicians

Practice addresses (Care Compare)

530 S Jackson St
Louisville, KY 40202-1675

571 S Floyd St
Louisville, KY 40202-3818
Phone (502) 629-2398

Hospital & facility affiliations

  • University of Louisville Hospital Hospital, Louisville, KY, CCN 180141

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
209900TNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Sep 18, 2018 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Jun 18, 2019 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Sep 18, 2018 Accepting new patients
University of Louisville Physicians, Inc. Current Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1531094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543536000000",
    "number": "1669968111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-588-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 S JACKSON ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021675",
            "telephone_number": "502-852-5851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATARZYCKI",
        "first_name": "MEREDITH",
        "middle_name": "MADER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-09",
        "last_updated": "2018-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "209900",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "3012692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "3012692",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300020101",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100557470",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K235880",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.