Individual provider Active NPI

Madelys Hernandez Urquiaga, APRN

  • Gerontology Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1689395642
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
3017009 Issued in KY
Practice address
3015 Wilson Ave
Louisville, KY 40211-1969
Phone
(502) 774-4401
NPI assigned
Sep 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3017009 KY
Gerontology Nurse Practitioner 363LG0600X 3017009 KY Primary

Addresses

Primary practice location

3015 Wilson Ave
Louisville, KY 40211-1969

Mailing address

1418 Garvey Dr
Louisville, KY 40216-3924

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230901003260 KY Practitioner - Nurse Practitioner 8224491550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Park Duvalle Community Health Center, IncGroup PAC ID 1658268974, 22 clinicians

Practice addresses (Care Compare)

3015 Wilson Ave
Louisville, KY 40211-1969
Phone 50277444011509

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Park Duvalle Community Health Center, Inc. CurrentSince Nov 18, 2024 Accepting new patients
Park Duvalle Community Health Center, Inc CurrentSince Nov 18, 2024 Accepting new patients
Park Duvalle Community Health Center, Inc. Current Accepting new patients

Locations

3015 Wilson Ave
Louisville, KY 40211
Phone (502) 774-4401

1425 W Broadway
Louisville, KY 40203
Phone (502) 245-0002

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1689395642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 GARVEY DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402163924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 WILSON AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402111969",
            "telephone_number": "502-774-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ URQUIAGA",
        "first_name": "MADELYS",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-08",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3017009",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "KY",
            "license": "3017009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.