NPIMap

Individual provider Active NPI

Phillip Albert Cetina, DO

  • Internal Medicine Physician
  • Louisville, KY
National Provider Identifier
1679151153
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
05848 Issued in KY
Practice address
200 E Chestnut St BLDG Suite303
Louisville, KY 40202-1831
Phone
(502) 629-5552
NPI assigned
Mar 29, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X R6172 KY
Internal Medicine Physician 207R00000X 05848 KY Primary

Addresses

Primary practice location

200 E Chestnut St BLDG Suite303
Louisville, KY 40202-1831

Mailing address

550 S Jackson St FL Street3
Louisville, KY 40202-1622
Phone (502) 852-5666

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
I20240829002299 KY Practitioner - Internal Medicine 6709222466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Liberty Univ College of Osteopathic Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

200 E Chestnut St
BLDG Suite303
Louisville, KY 40202-1831
Phone (502) 629-5552

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Internal Medicine CurrentSince Aug 1, 2024 Accepting new patients
Community Medical Associates, Inc. Internal Medicine CurrentSince Aug 1, 2024 Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
Norton Hospitals, Inc Past Accepting new patients

Locations

200 E Chestnut St
Ste 303
Louisville, KY 40202
Phone (502) 629-5552

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

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

Interoperability endpoints

  • Direct secure messaging: pcetina247849@direct.nortonhealthcare.org

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 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1679151153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S JACKSON ST FL STREET3",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021622",
            "telephone_number": "502-852-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E CHESTNUT ST BLDG SUITE303",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021831",
            "telephone_number": "502-629-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CETINA",
        "first_name": "PHILLIP",
        "middle_name": "ALBERT",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-29",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "KY",
            "license": "R6172",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "05848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.