Individual provider Active NPI

Mirzada P Kurbasic, MD

  • Pediatrics Physician
  • Louisville, KY
National Provider Identifier
1730163270
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
32906 Issued in KY
Practice address
555 S Floyd St
Louisville, KY 40202-3822
Phone
(502) 588-3440
Fax
(502) 588-3441
NPI assigned
Nov 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 32906 KY Primary

Addresses

Primary practice location

555 S Floyd St
Louisville, KY 40202-3822

Mailing address

PO Box 909
Louisville, KY 40201-0909
Phone (502) 588-3440

Other identifiers 2

IdentifierTypeStateIssuer
64329063MedicaidKY
200155590MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mkurbasic47361@direct.nortonhealthcare.org

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
I20110318000126 KY Practitioner - Pediatric Medicine 0941483606 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32906KYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Children's Medical Group, LLC Current Accepting new patients
Norton Children's Medical Group, LLC CurrentSince Mar 1, 2020 Accepting new patients
Norton Children's Medical Group, LLC CurrentSince Mar 1, 2020 Accepting new patients
University of Louisville Physicians, Inc. Pediatrics CurrentSince Sep 1, 2012 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Sep 1, 2012 Accepting new patients
University Physicians Group - Radiology Past Accepting new patients
Norton Childrens Medical Group, LLC Pediatrics Past Accepting new patients
Norton Children's Medical Group, LLC Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

411 E Chestnut St
Fl 1
Louisville, KY 40202

9702 Stonestreet Rd
Ste 100
Louisville, KY 40272
Phone (502) 588-0610

411 E Chestnut St
#1
Louisville, KY 40202
Phone (502) 588-3440

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

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

231 E Chestnut St
Louisville, KY 40202
Phone (502) 852-8500

550 S Jackson St
Fl First
Louisville, KY 40202
Phone (502) 852-0011

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

555 S Floyd St
Louisville, KY 40202
Phone (502) 588-3440

Organizations & group practices 8

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": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1730163270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-588-3440",
            "fax_number": "502-588-3441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S FLOYD ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402023822",
            "telephone_number": "502-588-3440",
            "fax_number": "502-588-3441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURBASIC",
        "first_name": "MIRZADA",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-29",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "32906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64329063",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200155590",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkurbasic47361@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "411 E Chestnut St # Street1",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402021713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.