Individual provider Active NPI

Michael Wata Luy, MD

  • Internal Medicine Physician
  • Evansville, IN
National Provider Identifier
1720333768
Registry record updated Sep 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01077251A Issued in IN
Practice address
421 Chestnut St
Evansville, IN 47713-1227
Phone
(812) 426-9372
Fax
(812) 858-4545
NPI assigned
Jul 16, 2012
Last updated
Sep 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036132602 IL
Internal Medicine Physician 207R00000X 01077251A IN Primary

Addresses

Primary practice location

421 Chestnut St
Evansville, IN 47713-1227

Mailing address

PO Box 3868
Evansville, IN 47737-3868
Phone (812) 450-6879

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20230601002413 OH Practitioner - Internal Medicine 5294969382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Carmel Healthproviders IncGroup PAC ID 9537073804, 140 clinicians

Practice addresses (Care Compare)

55 N High St
New Albany, OH 43054-7099
Phone (614) 627-1878

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01077251AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Carmel Healthproviders Inc Internal Medicine CurrentSince Jun 4, 2023 Accepting new patients
Mount Carmel Health Providers Inc CurrentSince Jun 4, 2023 Accepting new patients
Southern Illinois Medical Care Associates LLC Past Accepting new patients

Locations

6150 E Broad St
Columbus, OH 43213
Phone (614) 546-4400

775 W Broad St
Ste 200
Columbus, OH 43222
Phone (614) 627-1610

55 N High St
New Albany, OH 43054
Phone (614) 627-1878

Interoperability endpoints

  • Direct secure messaging: mluy2686687@direct.trinity-health.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1720333768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3868",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477373868",
            "telephone_number": "812-450-6879",
            "fax_number": "812-858-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 CHESTNUT ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477131227",
            "telephone_number": "812-426-9372",
            "fax_number": "812-858-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUY",
        "first_name": "MICHAEL",
        "middle_name": "WATA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-16",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036132602",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01077251A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.