Individual provider Active NPI

Daniel J O'Brien, M.D.

  • Emergency Medicine Physician
  • Louisville, KY
National Provider Identifier
1710040282
Registry record updated Jun 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
22338 Issued in KY
Practice address
530 S Jackson St
Department of Emergency Medicine C1H17
Louisville, KY 40202-1675
Phone
(502) 852-5689
Fax
(502) 852-4701
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 22338 KY Primary

Addresses

Primary practice location

530 S Jackson St
Department of Emergency Medicine C1H17
Louisville, KY 40202-1675

Mailing address

530 S Jackson St
Department of Emergency Medicine C1H17
Louisville, KY 40202-1675
Phone (502) 852-5689

Other identifiers 1

IdentifierTypeStateIssuer
64223381MedicaidKY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100203000457 KY Practitioner - Emergency Medicine 9931005675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22338KYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. Emergency Medicine CurrentSince Oct 1, 2012 Accepting new patients
University of Louisville Physicians, Inc. Current Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Oct 1, 2012 Accepting new patients
University Emergency Medicine Associates P.S.C. Emergency Medicine Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

530 S Jackson St
#C1H17
Louisville, KY 40202
Phone (502) 852-5689

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

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433116800000",
    "number": "1710040282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 S JACKSON ST",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE C1H17",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021675",
            "telephone_number": "502-852-5689",
            "fax_number": "502-852-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 S JACKSON ST",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE C1H17",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021675",
            "telephone_number": "502-852-5689",
            "fax_number": "502-852-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "DANIEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2015-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "22338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64223381",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.