NPIMap

Individual provider Active NPI

Mana Moghadamfalahi, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • New Albany, IN
National Provider Identifier
1689884876
Registry record updated May 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
01073646A Issued in IN
Practice address
1850 State St
New Albany, IN 47150-4990
Phone
(812) 948-4325
Fax
(502) 456-4440
NPI assigned
May 23, 2007
Last updated
May 5, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 01073646A IN Primary

Addresses

Primary practice location

1850 State St
New Albany, IN 47150-4990

Mailing address

PO Box 1286
New Albany, IN 47151-1286
Phone (502) 456-6211

Other identifiers 4

IdentifierTypeStateIssuer
50083645OtherKYPASSPORT
201153720AMedicaidIN
000000875489OtherKYANTHEM
7100240630MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20121204000526 KY Practitioner - Pathology 5294987954 Reassigns benefits to 2 organizations
I20140522002079 IN Practitioner - Pathology 5294987954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinical Associates LLCGroup PAC ID 3577456300, 28 clinicians

Practice addresses (Care Compare)

200 E Chestnut St
Louisville, KY 40202-1831
Phone (502) 897-9594

4001 Dutchmans LN
Louisville, KY 40207-4714
Phone (502) 897-9594

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01073646AINMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Nov 1, 2012 Accepting new patients
University of Louisville Physicians, Inc. Current Accepting new patients
Floyd Pathology Associates LLC Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2014 Accepting new patients
University of Louisville Physicians, Inc. Anatomic Pathology & Clinical Pathology CurrentSince Nov 1, 2012 Accepting new patients
University Pathologists, PSC Past Accepting new patients
Clinical Associates, LLC Anatomic Pathology & Clinical Pathology PastSince May 16, 2021 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

1850 State St
New Albany, IN 47150
Phone (812) 944-7701

1941 Bishop Ln
Ste 1018
Louisville, KY 40218

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 7

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430784000000",
    "number": "1689884876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1286",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471511286",
            "telephone_number": "502-456-6211",
            "fax_number": "502-456-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 STATE ST",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471504990",
            "telephone_number": "812-948-4325",
            "fax_number": "502-456-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGHADAMFALAHI",
        "first_name": "MANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2015-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": "01073646A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50083645",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201153720A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000875489",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100240630",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, IN

Sources for this page

Verify at the official NPI Registry.