Individual provider Active NPI

Paul Elliot Merenbloom, MD

  • Psychiatry Physician
  • Lexington, KY
National Provider Identifier
1679584510
Registry record updated Jan 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
23402 Issued in KY
Practice address
1101 Veterans Dr
Lexington, KY 40502-2235
Phone
(859) 233-4511
NPI assigned
Aug 9, 2006
Last updated
Jan 25, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 23402 KY Primary

Addresses

Primary practice location

1101 Veterans Dr
Lexington, KY 40502-2235

Mailing address

1101 Veterans Dr
Lexington, KY 40502-2235
Phone (859) 233-4511

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211214002175 KY Practitioner - Psychiatry 2769872332 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23402KYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Seven Counties Services, Inc. Psychiatry CurrentSince Dec 3, 2021 Accepting new patients

Locations

1020 E Broadway
Ste 101
Louisville, KY 40204
Phone (502) 589-8085

10401 Linn Station Rd
Ste 100
Louisville, KY 40223

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

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, 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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1679584510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 VETERANS DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405022235",
            "telephone_number": "859-233-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 VETERANS DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405022235",
            "telephone_number": "859-233-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERENBLOOM",
        "first_name": "PAUL",
        "middle_name": "ELLIOT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "23402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.