Individual provider Active NPI

Samer Jad Baba, D.O.

  • Anatomic Pathology & Clinical Pathology Physician
  • Louisville, KY
National Provider Identifier
1730522285
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
04703 Issued in KY
Practice address
530 S Jackson St
Louisville, KY 40202-1675
Phone
(502) 852-1816
NPI assigned
Apr 15, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 04703 KY Primary

Addresses

Primary practice location

530 S Jackson St
Louisville, KY 40202-1675

Mailing address

550 S Jackson St
Louisville, KY 40202-1622
Phone (502) 852-1816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201124002717 FL Practitioner - Pathology 7315283546 Reassigns benefits to 1 organization
I20260422003533 TX Practitioner - Pathology 7315283546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Nova Southeastern College of Osteo Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Regional Laboratories Pathology Services, LLCGroup PAC ID 9133244346, 132 clinicians
Gulf Coast Pathology Program PLLCGroup PAC ID 3476956194, 38 clinicians

Practice addresses (Care Compare)

11750 SW 40 St
Miami, FL 33175-3530
Phone (305) 227-5579

1313 Hermann Dr
Houston, TX 77004-7005
Phone (713) 527-5285

Hospital & facility affiliations

  • HCA Florida Mercy Hospital Hospital, Plantation, FL, CCN 100167
  • HCA Florida Kendall Hospital Hospital, Miami, FL, CCN 100209
  • HCA Houston Healthcare Tomball Hospital, Tomball, TX, CCN 450670
  • HCA Houston Healthcare Medical Center Hospital, Houston, TX, CCN 450659

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Regional Laboratories Pathology Services, LLC Anatomic Pathology & Clinical Pathology CurrentSince Jan 4, 2021 Accepting new patients

Locations

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

11750 SW 40th St
Miami, FL 33175
Phone (305) 227-5544

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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": "1365984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1730522285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S JACKSON ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021622",
            "telephone_number": "502-852-1816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 S JACKSON ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021675",
            "telephone_number": "502-852-1816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABA",
        "first_name": "SAMER",
        "middle_name": "JAD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-15",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KY",
            "license": "04703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.